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Posted: 8/12/17, 12:27 pm
Aria stood by the set of double doors at the rear of the ICU. Her foot was tapping nervously, her hands were shaking, and small beads of sweat lined her forehead. She was a touch pale, but still very much in control. The adrenaline pumping through her veins made her feel like she could burst any second there was so much built up energy. Come on... come on... she repeated over and over in her mind. Time was always so precious in emergency situations. Not that she didn't have complete faith in her team, but this case that was on its way sounded severe, complicated, and beyond anything her staff had seen before. She needed to handle this personally.
Even over the ambiance of the ICU, she could hear the low rumble of speeding tires coming up the driveway. "Places, everyone." she ordered, in a stern tone but not at all degrading. They were a team, and she needed them just as much as they needed her. Two of her nurse interns stood to her left with an electronic stretcher, with a built in scale. Another nurse stood by the ICU table, surrounded by all the necessary supplies needed for an intravenous catheter, administering of IV fluids, and injections of medications. When -or if, rather- they stabilized the pokémon, they'd attempt to draw blood and perform radiographs. Aria needed all the answers she could get, because the referring phone call stated that no one so far could figure out what had happened or was happening to this poor pokémon.
In a matter of seconds, the tires screeched to a stop and Aria burst through the swinging double doors, quickly followed by the two interns with the stretcher. A dark-colored SUV of some type slid to a stop in the barn, and two men in paramedics uniforms hopped out of the front seats. It was no ambulance, but it had transported the pokémon here safely and that's all she cared about. They lifted the back hatch open, revealing another paramedic. This one had blood stains on his arms and face, and a towel wrapped in a ball in his arms. A towel?? Aria mentally groaned, a little disappointed that these paramedics didn't even try to keep things clean and sterile. However, they were probably rushing and did the best with what they had.
Aria leaned inside the vehicle and practically ripped the pokémon from the paramedics arms, leaving the soiled towel behind. In a split second she laid the pokémon on the stretcher and they were on the move. As they rushed inside, Aria scanned the dark yellow fur of the pokémon's body and realized it was a Pikachu. Her heart ached almost instantly, having a Pikachu of her own and knowing how heartbroken she'd be if she ever saw him in this state. This was going to be rough on her if they couldn't help this little thing. "Follow us, we may need your help." she ordered at the paramedics she was leaving behind. They did as they were told.
Once they reached the ICU, the interns slid the stretcher onto the table. As the other nurse applied a tourniquet to the Pikachu's right arm, Aria pulled her stethoscope from her neck and shoved the ear pieces into her ears. Immediately pressing the diaphragm to the Pikachu's chest, she closed her eyes and the rest of the world around her disappeared for a moment. A heartbeat, good start. It took a few seconds, but there was a shallow breath as well. She listened closely, picking up on slight crackles upon inhale and exhale. "Be cautious around the chest, there may be pulmonary contusions." Aria warned, opening her eyes and pulled her stethoscope from her ears.
The nurse at the head of the table had already placed an IV catheter. She had just finished inputting the rate settings on the IV pump. "Twelve point three pounds." she heard one of the interns say nearby, who had read the Pikachu's weight off the electronic stretcher. Aria nodded, and reached for a dark amber bottle sitting on the metal tool cart nearby. She handed it to the intern while doing the calculations in her head. "Let's start with point oh five. If the patient's heartrate doesn't come up to within normal limits in 10 minutes, repeat the dose." Aria ordered, and the intern got started. In the meantime, her team already had an oxygen mask pressed against its nose and mouth, and EKG clips attached to each armpit and thigh. The numbers that flashed on the EKG showed a very low heart rate and blood pressure.
The atropine injection helped, but only a little. The Pikachu was still unconscious and breathing shallow. "Let's do a comprehensive chem to start with, and then try getting some x-rays." she suggested, and the team continued to follow her instructions. The blood draw was tricky, due to lack of blood pressure, but one of the nurses was able to draw a sample finally. Aria asked the paramedics from the referring clinic to help move the Pikachu to radiology while still on the stretcher. Aria covered her body with the protective equipment and shot the radiographs herself, allowing her staff to keep working. Afterwards, the paramedics moved the stretcher back into the ICU while she examined the images that popped up on the computer screen.
"Ouch." she said, wincing. This Pikachu had been crushed, basically. It had several broken ribs, a dislocated right shoulder, and a fractured pelvis. Evidence of bruising on the lungs confirmed her earlier suspicion. The other internal organs appeared to be intact, but this Pikachu was in for a long recovery. Aria was a little confused about why the Pikachu was transferred to her. It appeared to be pretty obvious that it was crushed by something, whether it be a car tire or something else. She could easily see what was wrong on the radiographs. Had the other clinic really not been able to tell that? Pushing the thought from her mind, she focused on the patient at hand and would revisit that question later.
It was a long afternoon. They managed to stabilize the Pikachu, get its heart rate and blood pressure back up to almost normal, and administer appropriate pain relief. Everyone involved had acted quickly and without hesitation, and Aria was proud of her team for working so hard. All they could do now was wait. She left two of her interns by its side to monitor it while she walked the paramedics back to their vehicle. "Thank you so very much for transporting her, and in such a timely manner. We'll do the best we can." Aria said, as they excited into the barn. They nodded, shook hands, and thanked her for everything she was doing. "Please keep us updated on her progress." one of them said, before climbing into the car. Aria agreed, and gave them each a wave before stepping back inside.
"Aria, you need to see this." her fellow nurse said, the moment she was back in the ICU. He handed her two printed sheets of paper that she recognized as the bloodwork results. As her eyes scanned over each numerical result, they widened. "What on earth?" she said aloud. The numbers were all over the place. None of it made sense. These results weren't even close to what she expected to see from shock or organ damage. In fact, these results weren't suggestive of anything at all, they were scattered about randomly. Her brain began to buzz, in an attempt to try to remember anything at all from her schooling that resembled what she saw. Looking up at her nurse with a worried expression, she frowned, "Stay with the patient, I'll be right back."
She skipped every other step on the way up to the upstairs apartment. She immediately pulled out her pokégear and began dialing numbers of her colleagues and professors from school. While she called, she stepped over to her bookshelf that was full of medical and reference books. She pulled several off the shelf and began to flip through them frantically. Nothing. She received very little information from her books or her references. Even the professors that did answer weren't sure what to say about the bloodwork levels. All they could think of was that maybe there was some sort of interference with the machine, that the lab equipment needed re-calibrated or that the nurse made a mistake while running it. Aria guessed she could try running the bloodwork again, but it had been so hard to get a sample to begin with.
Aria trotted back down the stairs with a few medical books in her arms. She chose to have faith in her staff and her brand new equipment, and chose to focus not on what caused the strange results but rather how to correct them. She laid the books out on the other ICU table and along side her interns and nurses, they collaborated. Using this medication and that strategy and being careful not to counteract this with that, they'd work on getting this Pikachu back to as normal as possible.
They worked around the clock. Twenty four hours had gone by and the Pikachu still showed no signs of consciousness. Aria took a brief nap overnight before getting right back to it. As the medications helped in some areas, others were getting worse. It was trial and error until they finally found a combination of medications that seemed to help without harming somewhere else. The Pikachu remained on the IV fluids and EKG, and at the 48-hour mark they had to add in a feeding tube. Aria very carefully inserted a thin rubber catheter through the Pikachu's nostril and down its esophagus. With that in place, they were able to syringe-feed liquid food rich in nutrients. Despite being unconscious, the Pikachu still needed its daily intake of food.
It was now 72 hours since admission. The interns and nurses were exhausted and had taken to shifts, taking turns sleeping upstairs in the apartment. Several times now Aria had to order food to be delivered to them, having only snacks and water at their disposal. Really there was nothing else to be done, aside from administering the medications when they were due, all they could do was wait. Aria normally had a rule, that if the patient didn't show improvement in 48 hours, they would humanely let it pass. There were always exceptions to the rule, of course, depending on the reason or cause behind the illness. However, Aria was a firm believer in not letting a pokémon suffer, and despite this Pikachu's bloodwork and stats showing improvement... it was still unconscious. Was it suffering? She began to ask herself as the time ticked on.
As the clock struck 2:00am, it had now been exactly 84 hours since the Pikachu arrived at her hospital. Her staff was spent, her resources were spent, and even she was spent. Aria began to consider bringing up with her staff the option of letting the Pikachu go. As far as they knew and the previous hospital knew, the Pikachu didn't have an owner. According to the paramedics, some good samaritan found it unconscious in the road and rushed it to the nearest hospital. Being that it was very critical and well beyond what they could handle, they rushed it here. As sad as the situation was, they at least didn't have a heartbroken trainer waiting in their lobby for the bad news. It broke Aria's heart too, knowing exactly how she would feel if she ever had to make this decision for Arashi.
As if on cue, Arashi tugged on her scrub pants. "Chu?" he asked, softly. "Yes, I'm okay buddy..." Aria answered, sure that Arashi was worried about her. She buried her face in her hands, closing her eyes and trying to think. Was there something she was missing? Was there anything else she could do? There was another tug at her pants. "Chu!" he said. This time it sounded more like he was trying to get her attention. She lifted her face to look down at him, only to her surprise, he was pointing elsewhere. Her eyes followed his and came to rest on the Pikachu, who was still strapped in on the ICU table. Only... wait... did its arm just move? Aria leaped to her feet and rushed to the table side. "Hello? Can you hear me?" she asked, leaning in close to the resting Pikachu and placing a hand on its head.
Ever so slightly, the Pikachu's eyes opened. A wave of relief crashed over her and she instantly burst into tears. The rest of her staff quickly surrounded the table, also as shocked as she was at what was happening. It was as if the Pikachu's eyelids weighed a ton, as every time it tried to open them they drifted back shut. "Oh goodness, you're conscious!" Aria let out, wiping a tear from her cheek. "Can you hear me?" she tried again, leaning in just a little closer. The room was silent for a moment before a weak response came from the Pikachu. "Chu..." was all it could say. The staff began to cheer, and Aria looked down at Arashi. He gave her a wide smile and a nod, confirming that the patient could indeed hear her.
Hugs and highfives occurred around the room. The tension in the air immediately disappeared, and Aria was full of hope once more. She had just about given up on this poor little thing. It still had a long road to recovery with all of those broken ribs and fractures, but at least it was conscious now. After a while, as long as the Pikachu continued to stay conscious, they could remove the feeding tube. They would continue to monitor bloodwork results, and as long as they continued to normalize they could wean off the medications. They'd continue the antibiotics and pain relievers of course, but the hope was that the Pikachu's levels would stay normal without the other medications.
Over the next 24 hours, the Pikachu continued to improve. It was very sore, and any movement caused it to wince in pain, but it began to eat on its own and even talk. Arashi stayed by its bedside, originally just to help with translation but ended up staying because he wanted to. He started to care about their new friend and wanted to look after her. Aria was proud of him, not only for his hard work and his part in its recovery, but he also provided an ear for her and someone to keep her company. Having this other Pikachu nearby almost seemed to take the edge off, Arashi seemed to be calmer and more comfortable around her, which Aria kept her eye on.
The following week was tough, but the Pikachu pressed on. Eventually, with some assistance from Arashi, she was able to stand and even take steps. Once she was able to move about and not be in pain, Aria gave her a gentle bath. Her fur coat had been a dark yellow color and Aria had assumed it was just dirty. However, even after a bath her fur was a deep yellow, almost burnt orange color. Aria assumed she was just born with darker fur than most Pikachu had. On the other hand, Arashi had taken a real liking to her. Aria wondering if he didn't have some sort of crush on her, the way he guarded her and helped her and looked after her. Arashi's attitude seemed to be softening as well, and he even showed Aria some affection here and there which was unheard of.
One evening, Aria called it a night and was getting ready to head upstairs. She called for Arashi, who always went to bed with her, and when he didn't come running she knew where he was. She found him in the ICU, curled up in a ball next to his new friend. The two were practically cuddling, fast asleep. Aria's heart about melted, it was such a cute sight. She chose to let them be, heading upstairs by herself to turn in for the night. As she crawled into bed and closed her eyes, she realized she might have to keep this Pikachu here with them. Arashi was attached to her now, she couldn't put her up for adoption. Maybe the Pikachu would want to stay? Seeing Arashi so happy made Aria very happy. She smiled as she thought it over, and when an idea for a name popped in her head, she was sold. She had named him Arashi after the word storm. This new Pikachu seems to have brought peace and serenity to his life. If the Pikachu wanted to stay, she would name her Serenity. Aria smiled as she drifted off to sleep, her heart as full as could be.
To be continued...
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