Career Decision

When the medical alarm rang out it was almost the end of the watch. Helena checked her monitor for the location of the emergency and her heart fluttered when she saw it was the gym. Emma would be in the Eagle Bay at this time of day and Alex had flight simulator practice, but Richie was usually in the gym. She tapped an acknowledgment and headed out the door of the lab. A stretcher was already being pulled by one her young trainees and the duty ER nurse. She caught Bob's eye as she headed out the door and he nodded a silent acknowledgment. They had handled medical emergencies together for years and knew the drill too well. He would send her updated info as soon as he received it.

Her slate beeped almost as soon as she entered the corridor. she pulled it from her belt and recognized the face of her youngest son. Before she could snap at him to sign off she noticed that his face was spattered with blood over top of the usual freckles. "Richie?" she asked without breaking her stride.

"I'm okay Mom. It's Billy Reilly. He was on the parallel bars and one of them broke! There's blood everywhere."

"We're on our way."

"Mama," at eleven, Richie seldom called her mama anymore. "I think it's an artery. The blood was pumping all over the place--"

Her team heard Richie's appraisal and changed from a brisk pace to a flat out run. Laurie was already on her slate calling back to Medical Center for Billy Riley's records and whole blood for a transfusion.

Helena felt no sense of relief that her son wasn't injured. That would come later. Right now she was too busy hoping she would be in time to save Billy's life. The gym was practically deserted-- unusual for this time of day, but Ian N'bombe, the rec room's supervisor met them, his dark face gleaming with perspiration and his usually unruffled demeanor nearly frantic. "I've been concerned about the gym equipment for some time Dr. Koenig--" he began as Helena rushed by him. He had obviously cleared the gym, but done nothing for the child who was laying on the floor in a pool of blood.

"Not now, Ian!" Helena said sharply. Her entire attention was focused on the two little boys on the floor by the parallel bars.

Laurie knelt by the boys, getting the attention of Billy, asking him quiet questions, and assessing the level of shock. Helena was on her knees next to Richard whose hand was pressed into the wound, and he was concentrating fiercely.

Halima Ofori knelt on the other side of Billy oblivious to the pool of blood in her concentration on helping. She watched carefully as Helena examined the wound. Helena was pleased with her actions. She would make a good doctor someday.

"You're doing fine Richie. You've stopped the worst of the bleeding."

"But we can't leave it this way for long. What can we do?" Richie asked curiously. "Is that his femur?" he added with interest, pointing out a portion of the wound.

Helena nodded, trying to keep Billy from hearing. "We'll need to stop the bleeding here, then get him into surgery to reconstruct the artery."

"We can't keep this up for long," Halima said, reaching out for the emergency medical kit from the lower shelf of the stretcher.

While Richie continued to hold pressure on the wound, Helena placed tourniquet above it.

Laurie who had been monitoring Billy’s vital signs while trying to soothe the young patient who was fading in and out of consciousness looked up at Helena suddenly.

"BP is falling, Doctor. Pulse is thready and his heart rate is over 130."

Helena’s worse fears had come to fruition. Billy was going into hypovolemic shock and if she couldn’t check it immediately there was no hope.

"Laurie, I need two IV’s started, stat. Use 10 gauge catheters, sodium chloride bolus." She had to try to get as much fluid into him as fast as she could before he went into cardiac arrest.

She signaled for Halima to take over telemetry from medical center. "Tell Dr Mathias we will need as much plasma as possible and clear out OR." She knew Bob already had Billy’s blood type on hand.

Richard, eyes wide watched his mother with fascination as she placed a pressure bandage over the wound and secured it. Helena looked up and caught his eye.

"Watch that real close, Richie. Let me know if it slips or starts bleeding again."

Helena moved to the patient’s head and began a cursory examination dictating the information to Halima who in turn reported it back to Medical Center. " Pupils slightly dilated and equal. Skin pale. no obvious cranial deformities, but placing a cervical collar." She motioned to Richie to come over. "Richie, I need your help. I want you to hold Billy’s head and neck very still like this." She showed him where to place his hands. " Make sure you don’t move it. I’m going to put a collar on him to keep it still."

Richie did as he was told taking special care to make sure Billy’s neck didn’t move. When his mother was done she gave him an encouraging smile.

"Now stay here and continue to talk to Billy. We want to keep him awake if we can."

Moving back over to Billy’s side, Helena checked the IV’s. Laurie was just finishing up with the second and they were running smoothly. She turned to Halima. "Status."

Halima looked at the read out carefully. "Blood pressure is low, but stable. Respiration: 35, Pulse: 120. Dr. Mathias reports that OR is ready and he is rounding up blood donors in case we need more."

Time was of the essence now and Helena knew it. "All right lets load the patient on the stretcher. OK, Richie, remember to hold Billy’s head still. Laurie, take care of the monitors and IV lines. Halima, we’ll lift him on three."

As soon as Billy was loaded on the stretcher, the team raced to medical center. Richie, riding at the head of the stretcher, maintained his vigil holding Billy’s head absolutely still.

When they entered the doors at Medical Center Bob Mathias met them and motioned Helena and her team into a waiting pre-op room.

As Helena hastily scrubbed for surgery she gave Bob an assessment. "At the very least we have a tear in the femoral artery. I think it’s more serious than that though. I think you should try to get a portable X-ray and try to get some cervical spine pictures. I didn’t feel anything obvious, but his blood pressure tried to bottom out on us. Could be a spinal cord injury."

Mathias frowned as Helena drew her scrub gown, cap and mask and entered the surgical suite where her patient was already prepped and ready for surgery. Helena knew he understood how bad this could be. Spinal damage in that area could incapacitate him for the rest of his life if he survived it. Taking the slate from his belt, Mathias called up the radiology department and ordered the series of pictures Helena had suggested. Then he began to scrub.

Helena looked over the wound very carefully. She knew that any false moves could set the femoral artery pumping again, making the precarious loss of blood even worse. Even though Billy had been volumated with fluids on the mad rush to Medical Center, sodium Chloride could not carry oxygen to the brain. It’s sole point was to keep volume in the circulatory system so that the heart did not fail. Only now was whole blood being infused into her young patient. His blood type had been rare and not much had been kept in stores. She made a mental note to correct that.

After the pressure bandage was removed, Helena clamped the artery making only an educated guess where to put her instrument. As she began probing the injury she made an astounding discovery. The artery was indeed torn, but instead of the small tear expected, there was a huge longitudinal rip. A wound such of this should have been fatal. Helena suspected that only Richie’s fast response in placing immediate pressure on it had saved his friends life. A child could bleed to death in mere minutes from such an injury. Billy was a very lucky boy. She only hoped his luck held.

"Doctor, blood pressure is falling!" Laurie was still monitoring Billy’s vital signs.

"Dopamine push!" Helena ordered. Billy’s heart was starting to fail. It was not able to exert enough pressure to maintain circulation. She watched the monitor as Laurie administered the drug. If they were lucky Billy’s blood pressure would start to stabilize.

"It’s working" Bob said from just over Helena’s shoulder.

Helena said a silent prayer and returned to the job of repairing the torn artery. If Billy’s luck would just hold out a little longer, she thought. But she knew it would be much longer before Billy was out of the woods and they could all rest easier.

Three hours later Helena walked from the surgical suite. Removing her soiled scrubs as she returned to her office. She was not surprised to see Dave Reilly standing at her door, wringing his hands, his face creased with worry. She knew all too well the frustration of having to wait while your child’s life hung in the balance. She reached out and touched him on the shoulder. "Come into my office, Dave."

He seemed to come out of his daze at the sound of his oldest child’s name. "Yes, she fine. Eva Zoref is with her. They’re very close." He looked up. "When can I see him?"

Helena reached over and touched the necessary buttons on the terminal on her desk. The screen indicated that he was in post-op recovery and doing well. She would have rather waited a while, but she knew every moment Dave had to wait was an agony. "I think you can see him now. Remember you can’t stay long and he is still under the effect of the anesthesia so he won’t know you’re there."

She led him down a corridor to the recovery room. She wasn’t surprised to find Laurie and Halima at the boy’s bedside. Their shift was long over, but in a situation such as this they had a personal interest and they wanted to see the patient through. She turned to Dave. "Laurie will stay here with you if you need any thing. You can stay for ten minutes." She turned to leave, but then stopped and turned, "I’ll let you know if anything happens. Right now he needs lots of rest. So do you."

 Helena watched as Laurie moved to allow Dave closer to the bed.

Laurie said softly to Dave, "He’s quite a young man. When we picked him up at the gym he was very brave." She began tucking the covers around Billy’s body and checking the leads on his vitals monitor.

Dave looked at her like he had not known she was in the room before. "Yeah, he’s that kind of kid." A tear ran down the big Irishman’s face. "I’m sorry. I just can’t bear the though of losing him, too." Dave’s body trembled.

"I believe you mean that." He said as he looked into the nurse’s eyes. Wiping away the tears he returned her smile. "Thanks."

Helena was certain that the Reilly family was in good hands, and she slipped out of the room. Laurie was wonderful with children, and compassionate with the parents, which Helena had learned first-hand when Emma had needed surgery years ago.

Stopping only briefly at the duty nurse’s station, Helena headed out of Medical Center. She was beginning to have that shaky feeling she always got after a long stint in OR. It was partly adrenaline rush and partly a reaction to fear. She was an adequate surgeon, but it had never been her specialty or her interest on Earth. Still, she was all they had here.

Helena’s medical team was spread thin, and they did their best, but cases like this, especially involving children, terrified her. She had missed dinner with the family, but knew John would have checked with her staff and fed the children. She nearly tripped over Richie as she walked out the Medical Center doors.

"Richie, what are you doing here?" He was still wearing blood soaked gym clothes. He had, however, washed face and hands.

He scrambled to his feet. "Is he all right, Mom? Is he out of danger, now?"

Helena took her son’s hand and drew him along the hallway. "He's out of surgery and holding on to life. Why are you out here? You should have gone home hours ago."

"I wanted to make sure he was all right. They told me I couldn’t hang around in Medical Center so I waited out here."

"All this time? Does your father know where you are?"

"Richie nodded. "He said I could wait and come home with you."

Helena sighed. She doubted that John had expected him to sit in the hallway for hours but she knew that Richie had picked up all of Alex’s word games and could ask permission to do practically anything in a way that John would have to agree to. They boarded the travel tube and Helena sank wearily into a seat. Richie crouched in the seat next to her, watching her carefully.

"What?" she asked. Weariness was about to overwhelm her. She idly wondered if Richie would have to wake her up at their stop.

"Can I watch you operate on someone sometime?"

Helena looked at her son blankly, unsure how to respond.

"Please?" Richie met her eyes earnestly. "It was really neat seeing the arteries and bones and muscles. I mean, I didn’t want Billy to be hurt or anything, but getting to see his insides… I just… well, I wanted to see how you fixed him too. But I knew you were too busy for me to ask then. Mama? Are you all right?"

"Just really tired, Richie." The travel tube was slowing down. She took his hand. "I was very proud of the way you helped Billy today. If you hadn’t stopped the bleeding the way you did, he would have died."

His eyes widened. She had stated that very bluntly, but she felt he needed to know that. She considered his request. "I’ll try to arrange for you to observe an operation some time soon. A scheduled operation, not an emergency."

The door opened and they stood.

"Thank you, Mama," Richie hesitated, then continued. "You know I want to be a doctor…" He slipped his hand into his mother’s. Helena got the feeling that he was buttering her up for something.

"Well, I’ve been keeping up with my own school work, and I’ve talked to Halima, and she showed me the stuff you started having her read when she stated studying with you. I’ve been reading them, and I’ve almost caught up with her. Can’t I help out in Medical Center like she does? Maybe I could help take care of Billy."

She smiled, wondering why her children were so eager to grow up. She knew how desperately Alpha needed them, but they were so young. "You haven’t finished school yet."

"Emma started working with Uncle Alan part time, when she was littler than me."

"Emma was learning math at an accelerated pace," she countered, although she knew that Alan had also been throwing in engineering and mechanical concepts just as fast as Emma could absorb them, which had been quite fast.

"And I want to learn medicine," Richie said simply. "I promise to get all my school work done too."

They had reached the door of their apartment. She turned and looked at her son. He was not quite as tall as her yet, but that would probably change soon. The state of his gym clothes combined with his determined look verified his seriousness. His actions this afternoon also spoke well of his commitment. Perhaps it was time to give him a taste of the career he was so determined to obtain. "The best thing you can do for Billy is visit him often, both while he’s in medical center, and after he’s released. It’s going to take him a long time to recover. But you can begin to help out in medical center too. It won’t just be fun stuff. A lot of the boring things that I’ll have you do are important too," she warned.

He nodded eagerly, a grin breaking out on his face. "I’ll do whatever you ask."

"Right now, I need some sleep. Tomorrow come by after school and be ready to show me what Halima has loaned you. We’ll talk about what you’ve read and I’ll plan a course of study for you."

Just as the apartment door opened, Richard threw his arms around his mother and gave her a kiss on the cheek. "Thanks Mom," He said and bounded inside.

John was standing in the doorway.

"Hi, Dad. I’ve got to go shower."

The sight of Richie’s bloodied gym clothes and his wife’s tired countenance gave John a start. He held out his hands to his wife and drew her inside. "What was that all about?"

Helena knew John would insist that she eat, and leaned against him, more than ready to allow him to pamper her a bit. "Our son wants to be a doctor." The statement gave her a warm glow inside, and made her feel a bit better.

"I thought we’d already determined that."

"He wants to begin training right away."

"Isn’t he a little young?"

"He pointed out that Emma was pretty young to start training too."

"Good point. So what are you going to do?"

"Start training him. He earned that today with his actions in the gym. He undoubtedly saved Billy’s life with his quick thinking and quick action."

"How is Billy?"

"Hanging in there. Luckier than any little boy has a right to be."

"He’ll make it?"

"I believe so. Only because Richie was with him." She yawned and smiled. Her son was going to be a doctor. Her father would have been quite pleased with his grandson’s career decision.