Bobby Akart - Desolation

“He’d just dropped below the surface when we found him,” said Jessica. “I performed CPR and intubated him to force air into his lungs. He regained consciousness for a brief moment before passing out.”

“You intubated him?” the doctor asked.

“Yes, my name is Jessica Albright. I’m a paramedic with the WET team.”

A look of recognition came over Dr. Golic’s face. “I thought I’d seen you around. You likely saved this young man’s life, Jessica.”

“Oh, thank God!” exclaimed Sonny as he broke down crying. He looked past the doctor toward the door. “May I go see him?”

“In a moment. The nurses are cleaning up and getting him into a gown. It’s a tedious job because he doesn’t need to be jostled unnecessarily. Plus, let me explain where we are in his treatment.”

Sonny’s chin dropped to his chest, but he nodded his understanding.

“Are there complications?” Jessica asked.

“Like I said, your early intubation of the patient made all the difference. The mechanical ventilation was able to keep his arterial saturation at near ninety-two percent. Naturally, because of his time in the water, it was difficult to get accurate readings on the pulse oximeter due to vasoconstriction. However, using the oximeter on his earlobe gave me a reading I was comfortable with.

“His body temperature was a real issue. As we all know, the temperatures in the coastal waters are at least ten to twelve degrees cooler than normal. Even under ideal conditions, remaining in Florida Bay for that length of time in mid-November can bring on hypothermia. We’ve employed some thermal insulation protocols to bring his temp back to normal.”

The doctor paused, and Jessica sensed she was equivocating or perhaps stalling. Sonny was antsy to see his son, and he deserved to know the entire medical prognosis, so she repeated her question.

“Complications?”

The doctor grimaced and nodded. “He was near death when you rescued him. Not surprisingly, he was suffering from dysrhythmia, a medical term for an abnormal heart rhythm. Even advanced cardiac life-support interventions are often ineffective with patients who have low core body temperatures. We tried atropine and lidocaine, administered intravenously. However, I wasn’t satisfied with the results. We used defibrillation to steady his heart rate, but we have to continue to monitor it.

“Once he’s stable, I’ve ordered the team to undertake gastric decompression to deal with the amount of water he swallowed. We’ll also continue to push fluids to help him recover.

“Lastly, it takes up to six hours for lung injuries to present. We’ll continue to monitor him for wet lung sounds, productive cough, and, of course, his irregular heart rate.”

“My god, how can I tell his mother?” asked Sonny, who was overwhelmed by the doctor’s detailed explanation.

Dr. Golic was about to respond when the team of nurses exited the trauma room. “Doctor, the patient has stabilized as his body temperature increased.”

“Great news,” said Dr. Golic. She turned to Sonny. “Mr. Free, you’re going to be able to tell Jimmy’s mother that her son had an intense desire to live under the worst of circumstances. He needs your love and support now. Keep your thoughts positive and pray for him.”

Sonny nodded and looked toward the door. He didn’t have to ask permission, as Dr. Golic knew he was anxious to go inside. She stepped back and pushed the door open but issued a note of caution as she did.

“Please stay calm. He looks like he’s been through hell, and in a way, he has. However, your son is a fighter, and he needs his father to fight alongside him.”

Sonny couldn’t stop the tears from flowing, and he thanked the doctor before slipping inside. Peter thanked her as well and followed Sonny. Jessica hung back.

“Dr. Golic, have you withheld anything or sugarcoated it for Sonny’s benefit?” It was the type of question that some medical professionals would take offense to, but not Dr. Golic.

“That’s all of it,” she replied with a sigh. “There is, however, one matter that I need to raise that only you can probably answer.”

“What’s that?” asked Jessica in a concerned tone.

“How did you find him? By that, I mean was he underwater already or on the surface?”

“We were searching and spotted him from a distance, waving his arms over his head. From his body movement, he appeared to be standing in shallow water. Then, suddenly, he slipped below the surface. When I dove underwater to pull him out, he’d apparently lost his footing and fell into a trough created by the current.”

“For how long?” asked the doctor.

“Underwater? I can’t be certain.”

The doctor grimaced, glanced toward Jimmy’s room, and then reached for Jessica’s arm. She led her several feet away from the door so their conversation couldn’t be overheard.

“Increased duration underwater increases the risk of death but also the potential for severe neurologic impairment. If he was below the surface for less than five minutes, the chances are less than ten percent that he’ll suffer diminished neurologic function. Over five minutes? The percentages rise to fifty-fifty. More than ten? Then I can almost assure you of some type of neurological damage.”

Jessica’s eyes grew wide. All of her training had been focused on rescue and resuscitation. She’d never considered the impact on the brain for a drowning victim.

“Okay. By underwater, do you mean unconscious and not breathing?”

“Yes, if you know.”

“Again, I can’t say for certain, but I’d put it at more than five minutes and less than ten. How much of that time Jimmy was holding his breath, which he’s very good at, versus being in an unconscious state is anybody’s guess.”

Dr. Golic made several notes on Jimmy’s chart and then looked down the hallway toward the nurses’ desk, where another patient was being assigned a room.

“I’ll have a neurologist look in on him once he regains consciousness. He’ll assess the young man’s mental condition. I just need to emphasize to you that full neurological recovery rarely happens after ten minutes of normothermic submersion. This doesn’t need to be shared with his parents yet. Let’s keep him alive first.”

With those ominous words, Dr. Golic left Jessica standing in the hallway alone. For the first time, she broke down in tears.

Sunday, November 10

Mariner’s Hospital

Tavernier, Florida

Jessica checked her watch again. It had been forty-five minutes since she’d left her boat parked at Mangrove Marina in Hurricane Harbor. The deputy had been kind enough to offer her time to watch over it, but she couldn’t count on her staying much longer. She needed to relieve the deputy, and besides, Jimmy had not regained consciousness although his vitals had stabilized.

“Guys,” she began, “I’ve gotta get back to the boat. Plus, I’m sure Hank will arrive with Phoebe, and they’re only gonna allow so many of us in the room with Jimmy.”

“How many?” asked Peter.

Jessica shrugged. “Three, maybe four, but I doubt it. They don’t want him to feel overwhelmed when he comes to.”

“Maybe I should—?” Before Peter could finish his question, there was a gentle knocking at the door before it slowly opened. Phoebe’s worried face appeared.

Sonny immediately rushed to her and pulled her the rest of the way inside. Peter held the door while the parents consoled one another. The tears began to flow again as Sonny relayed to Phoebe what they knew about Jimmy’s condition.

Hank and Mike filled the doorway, craning their necks over the distraught parents to catch a glimpse of Jimmy. Mike had spent plenty of time in a hospital bed of his own lately, so he knew what to look for on the monitors near Jimmy’s bed. He frowned when he studied the cardiac monitors. Jimmy’s body was fighting to live, but his heart appeared to be struggling.