Armageddon Saga
Chapter Thirty Nine:
Emergency/Trauma/Icu
By the Lady Sirona  ladysirona@LadySirona.com

     They soon arrived at the Emergency Department only to be denied any access to Buffy or Kendra. Angel was frantic.  She had survived the battle, only to be brought to the hospital and now they were being kept apart?  She was in the resuscitation-Trauma room, and there could be no visitors. Giles and Angel were pacing in the waiting room.  Willowwas sitting next to Xander trying to keep occupied... "How is she?" Xander asked every medical person as they came near, but he never got an answer. Time crawled.

     Kendra had received a broken leg and was under observation for further injuries.  Shewas not as seriously hurt as Buffy had been, and had been taken into another area of the Emergency Room.  She was being admitted to The Orthopedic team's care, and would be admitted to the regular medical floor of the hospital.  Kendra would be healing, and SamKubuto, her Watcher was with her.
     Angel had gone to the admissions office, and gave them the information they needed totreat her.  Angel and Giles decided enroute to the hospital to keep the emergency "Doe" Status they give all new trauma's, and so she was continued to be called 'Cheryl Doe' that she obtained when she first arrived in the hospital.   The hospital was more than willing to put any name on the account Angel wished,  since her medical care was being paid for in cash from Angel's resources. This status made her a VIP of sorts in the hospital, and hopefully bought them a few special favors.
     Hours passed and it seemed that time crawled for the Slayerettes. Finally, the Doctorcame out to speak with Angel and Giles.  "Excuse me, you are her father?" a doctor asked Giles.  Giles nodded.  "And you?" he asked Angel.  "I'm her husband." Angel answeredquickly. They had no problems with misleading the hospital, they were not about to dealwith the bureaucracy with a minor, injured and out of country,  without having a real say in her care.
     The Doctor looked at the anxious family members.  This was the only part he hated abouthis job.  He took a deep breath and started. "She is currently severely critical and very unstable. She has some moderate abdominal bleeding in her Liver and Spleen, but it seems to have possibly have stabilized.  We are continuing to monitor her hemoglobin and Hematacrit known as her H/H every 4 hours. So far, her H/H has been stable, but we will have to see.  If she starts to bleed again, she will require surgery.  She has flail chest, where several ribs were broken and punctured her lung causing bleeding into the thoraciccavity, she has required two chest tubes to drain the blood and open the lung up. She hasbled into her chest quite a bit, and has required quite a few blood transfusions. I am not sure of the count right now."  He looked at the handsome young man married to this unfortunate young lady.  Fate was cruel to people often, and Trauma was often the cruelest."She may require to be placed on a ventilator if she cannot maintain her oxygen status. We will have to see."
     He continued. "She has a fractured left clavicle, or collar bone as it is sometimes called,and a fractured left lower leg which will eventually require surgery and pining. "TheDoctor took a deep breath, and now came the hard part. "I am sorry, but she lost one of the babies."

     "One of the babies?" Angel asked confused.  She was pregnant with a baby, but…babies?

     "Yes, we did an abdominal ultrasound, as we do with every severe trauma.  She wascarrying triplets; two are still alive, I am sorry to have to tell you that one died. How wellthe two remaining are doing with all the injury and problems is unknown.  As for the third, we hope she'll reabsorb it, or in a worse case scenario,  it could decompose and she could become Septic... very sick from it... and that could be life threatening."  Angel thought that considering she was the Slayer, he believed, hoped, the former would occur.

     "She'll be ok?" Angel asked. He knew the Doctor couldn't tell him that...He knew theDoctor had just listed many severe injuries... but he needed to hear she would be ok.His heart which no longer beat, ached in his chest with the grim possibility of her injuries.  "I cannot promise. Yes, so far, I believe there is a probability she'll live." The Doctor looked at the man whom he did not know was a vampire, a vampire that stoodterrified at the possible death of one 17 year old girl.

     "I believe there is a slim chance she will be OK. She is not out of the woods yet... She was severely internally injured, there is always the possibility,  very badly.  We need to keep her in the intensive care; she will be in for several weeks.  If she goes into Septicemia we will need to give IV antibiotics to assure she won't get toxic from the fetal demise."

     Angel nodded. He knew this was all logical for the type of injuries she had. "When can Isee her?" He asked hopefully.  The doctor looked at him. "Now, but don't upset her.  She needs to rest."

     Angel and Giles walked into her room in the intensive care unit [ICU].  They saw her and was alarmed at her appearance, she was all pale and  looked oh so frail in the hospital bed. Her body was monitored through wires and tubes.  Angel stared at the monitors in complete confusion; He had never seen anything like it.
 
    Giles noticed that on the door was a blue sticker with hands reaching up, he realized itwas a sign of fetal demise, for those who would care for her to know what had happened to her.
     The smell of blood permeated the room washing over Angel's senses. The smell ofBuffy's blood mixed with others.  The sweet enticing aroma of blood called to his demon, Angel felt his incisors start to lengthen in response to the blood smell. This was going to be hell; he hated hospitals.
     Angel looked closely and saw that blood was in the tube that came from her nose and went to suction... he could see blood in the tubes that came from the chest and drained to containers on the floor, "chest tubes" his mind told him, and he looked in fascination at the bubbling blue water and the bloody drainage.  When he was human, such injury would have been fatal without even an option.  That she was still alive was amazing to him.
     He overcame his fear and walked over to her. "Buffy." He called to her softly. She rousedfrom her morphine-induced sleep to Angel's soft call.  "Buffy, I'm here, they finally let me in.  I love you.  I need you Buffy.  I almost lost you."  He dropped to his knees next to her bed taking her frail hand into his hand.  She looked so sick and frail.  Fear built in him.  He almost lost her... and still might!

     "Angel?"  She aroused and gently stroked his face with her right hand.  "I lost... our baby, Angel... I am... so sorry..." tears streamed down her face.  He realized she was short ofbreath, and every word was a supreme effort.  He looked at her.  Here she lay in the hospital bed, nearly on death's door, and she was sorry she lost his child?

     "Buffy you carried triplets, you have two left Buffy.  You were carrying triplets."  He tried to calm her and reinforced her possession of the two as he hugged her gently.  "There are two still alive." She looked into his eyes with astonishment.  He felt her amazement. Didn't they tell her? Or did the drug make her remembering too hard for her?

     "Two... I had...  triplets?"  The realization slowly sank in.  She still had twins.  Angel's twins. Her face lit up with pride and happiness.  She didn't lose all his children, and now she would have twins... Angel's children!

     Angel was remembering how rough he was the night they returned from the Gypsy camp and now he regretted he hadn't been more loving and gentle.  "I'm sorry for how rough I was the time we were together after we got back from the Gypsy camp...." She stopped him with a hand weakly on his lips.

     "Shhh.  I wouldn't...  want it... all the time, but you...  always treat me...  like a china doll, like...  I'll break.  I loved... being totally...  possessed by you....   It was....  Awesome!" She blushed.  She looked over Angel's shoulder and noticed that Giles was hearing their entire conversation.  Angel had gone from secretive and shy to not giving a damn who heard his passion for her... would wonders never cease?

     "Awesome?"  He was dumbfounded.  She really did like the rough aggressive love making of Angleus!

     "Yeah.  I felt...  like I...  was totally.... yours.  I was.... your woman."  She stopped and panted between every few words.  She was so short of air, but needed to tell him what she felt, afraid she would never have another chance. "It felt....  wonderful!  It was...   as if .... you finally ....claimed me.  I don't...  always want it.... that rough,  but it..... wasawesome.... to know... it is there.... when I.... want it."  She snuggled her hand into his hest.  "It was.... right out.... of a romance...  novel." She stopped talking, to winded to speak.

     "It was me, after Tirla blended Angel and Angelus.  You were making love to Angelus."Angel hid his head.  It shamed him that the demon had even touched his woman, and treated her so roughly.

     "Then you...  don't claim...  me as...  yours?  You don't...  want me?"  Tears welled in her eyes.  Angel didn't want her as fully as she thought?  He didn't claim her as his?

     "Oh God yes,  I do."  Angel held her hand to his lips and kissrf it.  She was so precious to him. "Buffy, I have always felt that way.  I just was afraid to do so, to show it.... I was afraid that you would resent my chauvinistic tendencies..."

     Buffy looked at him with drowsy sleep filled drugged eyes. "Then shut up... and kiss me."Being smart, he did so. She drifted off to sleep as they kissed, assisted by her need to sleep to heal and the medication given for pain.  They watched as she slept for awhile before the nurses shooed them out.

     After their visit, they were informed that she was on restricted visiting hours and sheneeded to rest and after Willow and Xander saw her, they were all sent home. When theyreturned to Tirla's estate, the discovered that the Watchers who had lost their Slayers were gone.
     Giles could only imagine their pain, and was grateful he didn't share their fate.  He knewthat he still might, but at least she was in a hospital, medicated for pain.  Their Slayers had fallen in battle and died to save a world that never knew nor probably cared for their existence. All over the world he knew there were new girls being told of their fates to be Slayers. Girls who would battle evil and die in its war.
     Sam Kubuto came up to Giles. "I am glad Slayer Prime survived.  She lost the baby as the prophecy foretold?"  His speech was tight.  His worry for his own slayer Kendra painfully obvious in his manner and voice.

     "Yes, except she had triplets, so she still carries twins."  Giles smiled at the memory of Buffy's happy smile when she realized she still carried Angel's children. Buffy so wanted Angel's child, and now she carried two!

     "Twins?  The Millennial Slayer and Watcher?" Sam Kubuto asked as he referred to a longthought mythical prophecy... Giles stared at him...Could they be?  "I'm not sure."  Giles thought a moment and smiled.  All sorts of possibilities were arising.

     Angel paced around the library all day, restless, agitated.  He needed to be at her side and couldn't since he was locked into the castle, by the sun. Xander and Willow failed miserably at trying to distract him.  They stopped trying when he just growled at any attempt to distract him from his pacing.
     The call came in the late afternoon.  Buffy had taken a turn for the worse... she had become Septic, and apparently started bleeding again, and had been taken into surgery suddenly.  She had the nurses’ call for Angel; she needed him they told him. As he couldn't leave while the sun was up, Angel was frantic.  Giles, Willow and Xander went immediately to the hospital leaving Angel to wait for the sun to set. When sunset finallycame he bolted to the car and drove in to town to see Buffy. The sun was still a blaze of red in the sky burning his skin as he raced to the hospital.
     When Angel arrived at the hospital, he found out that the Doctors had wanted to terminate her pregnancy, but she had refused.  Before going to surgery and being put onthe ventilator, she had forbidden them to terminate her pregnancy, even through it was most likely the fetal demise that was making her ill.

     When they finally brought her back to the ICU from Surgery, Angel was shocked to seethe damage and ravages the stress was doing to her body.  IV's were running into her through numerous intravenous sites, and at incredible rates. Adding up the fluids running into her from all the IV pumps,  he realized she was taking almost 2000cc/hour, almosta half a gallon and hour of fluid was coursing into her body!

     A long yellow multiple lined IV site was coming out of her right clavicle. The nurse described it to him as a "Swan Line" and told how she could use it to measure how well Buffy's heart worked, what her fluid status was, and how well her body was handling the sepsis.  The nurse explained how sepsis made the vessels of the body leaky and the blood vessels dilate which causes the blood pressure to drop, and close monitoring was essential for their control for the incredibly strong drugs she was on to keep up a blood pressure.

     A line came out of her wrist and measured her blood Pressure. The nurse called it an "Art line" or arterial line. The nurses also used it for access to draw blood for lab tests. Angel watched the throbbing beat that matched her heartbeat. The numbers were horribly low, 88 to 91 as a top number.  The nurse explained 120 was a normal number.

     Angel saw the damage his children were doing to her body, in addition to the initial injuries.  Sick with worry, he went out to the nurses’ station and luckily found her doctor. "How is my wife?" Angel asked. He was frantic; he felt she was dying.

     "She survived the packing of her liver, it was fractured and had started bleeding.  We lefther abdomen open, she is still unstable, and she lost a lot of blood and has a very low blood pressure.  We are giving a lot of intravenous fluids and she's on dopamine and possibly we will have to go to levophed if necessary to keep up her blood pressure.  We are giving her antibiotics."

     The Doctor looked at Angel, anger flashing in his eyes. "Where were you today? We called and called, she had been asking for you before she went into surgery." The Doctor was obviously not impressed with the man who never answered his wife's cries for him to be at her bedside... it had been heart breaking to watch.

     "I wanted to come... but I couldn't, I have severe sun allergy." Angel hated to tell himanything, but he felt he had to.  He couldn't bear to think that they didn't think he loved her...  "I couldn't come until the sun set.  Is she going to be ok?"

     The Doctor looked at him surprised; a real sun allergy was very rare.  "I don't know.  I had wanted to terminate the pregnancy, but she refused.  Said it was her only chance to have your child."  He looked at Angel closely as he winced. "She is young.  If she survives,  she could always have another child... but continuing this pregnancy with herinjuries just very well may kill her."

     "I have a... medical problem.  I'm sterile now.  It was a miracle she conceived at all."  He winced as he spoke, regret coloring his words.  "But if it is a choice between her or the children, I want her."  The Doctor nodded sadly..."I understand that.  But I have no choice.  When she was capable of making a medical decision, she stated her beliefs and her choices.  I must abide by them.  I advise you to go in and see her. If I were you I wouldn't leave her side until she is stable, especially if you can't travel.  I will write an order, permission for you to be at the bedside at all times. Please respect the needs of the nurses caring for her though." The Doctor left Angel to wallow in his fears.

     Angel entered the room and sat in a chair next to Buffy.  She was heavily sedated and didn't know he was there, her breaths rhythmically controlled by the ventilator attached to the tube going down her throat. He looked at her fear gripping his heart... he may still lose her. "Buffy."  Angel spoke softly.  She opened her eyes and saw her vampire lover at her side.  She knew it must be night.  Where did the day go?
     She smiled around the tube.   Her face was drawn.  Her skin was beginning to be puffywith the fluids running into her veins.  He glanced at the monitor.  Her heart was beating too fast, 130-140, her blood pressure was far too low, 89/39.  He looked at the PA number and didn'tknow what it was supposed to read, but it was 12/4 and the CVP read 0 to 1...
     "I don't want to lose you Buffy."  He sat in the chair at her bedside and took her hand and brought it up to his lips.  "Please Buffy.  Do what needs to be done so you won't die!"  He held her hand to his face, blood stained tears coursing down his cheeks. "They'll die ifyou die. Please Buffy!  I can't lose you!"  He was frantic.  "Please Buffy!"

     She wanted to reassure him, to calm him... but she couldn't muster the strength to stay awake... she drifted off into arms of sleep, with him holding her hand.

     Angel sat at her side all night.  He helped the nurse bathe her and turn her.  He watchedher vital signs.  They slowly worsened through the night.  The nurses explained her care and what they were doing, but he knew what was happening. Buffy was dying.

[Side note.  The unfortunate woman I based Buffy’s case on with the fetal demise survived her round with the sepsis.  She came back to visit the nurses who cared for her on the unit on 10/10/99]

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