Don't Even Want To Talk About It
Chapter 4 - Vibrations in Air
Disclaimer: I see nothing, I hear nothing, I speak nothing, I definitely own nothing!
Word Count: 3700
Christina’s POV
Christina estimated the time to be somewhere around three in the morning. She put her hands on her shoulders and raised her elbows skywards, feeling the tense muscles pull with strain. She looked around the on call room, taking in the sleeping figures of her fellow interns…well, minus one. George and Izzie were on the bottom bunk of the bed opposite her, entwined together in a way that, had she been more awake and had it not been three am and had the notion not been so absurdly outrageous, looked sweetly intimate…in a gross and incestual kind of way of course. Meredith was directly above her; she couldn’t see her, a slight dip in the mattress above her head, the discarded sneakers by the doorway and the god-awful snoring giving away her presence. It was the snoring that has woken Christina with a start and she wondered how on Earth Derek managed to get any sleep. She groaned and contemplated poking the mattress with her toe to stop the sound but caught herself at the last minute and just listened. Memories of Meredith’s blue lips and chalk grey face and distinct lack of a heartbeat flooded her senses and in that minute she decided that the snoring was the sweetest sound she had ever heard…maybe that’s how Derek slept at night.
Christina had never had a sister, she’d never had a best friend, in fact she wasn’t even sure she’d ever had any normal friends before either, at least not since junior high when classmates became competitors, rivals…adversaries. She still wasn’t sure how to define her relationships with this mismatched group of thrown together individuals. She was fairly sure Meredith was her friend, she was definitely her ‘person’, and did being someone’s ‘person’ automatically make them your friend as well? She was ridiculously out of practise when it came to defining these things. She guessed Izzie and George were also her friends, they were each others ‘person’, that much was obvious, but she figured they could still be her friends even if George was too flaky and indecisive and Izzie too blonde and emotional. Christina’s thoughts flicked to Alex, he definitely wasn’t her friend, in fact her ‘whatever’ with Alex reminded her of the ‘whatever’s’ she had shared with her classmates. He was the competition, pure and simple. She wondered briefly who Alex’s person was, if she and Meredith had each other and Izzie and George had each other then who did that leave for Alex?
Dr. Bailey had burst into the room a few hours earlier wanting a contact number for Alex’s next of kin, apparently his personnel file in HR had a mysterious blank where most people put mother or aunt or brother. The interns had looked at each other in stunned silence, simultaneously realising that they didn’t even know if he had any siblings let alone a contact number for a mother or a father or a ‘person’. Izzie had answered that his mother lived in Iowa still but that she didn’t think they were in contact and that he definitely didn’t speak to his father.
‘And the wife? The one that he had but doesn’t have any more? What’s the story there?’
‘Kelly,’ Izzie answered, her voice thick with alcohol and tears and shame.
‘We’re not totally sure. He didn’t actually say it so we’re just assuming really…that she’s…gone, uh…died…that she died. We’re fairly sure that’s the story.’
Dr. Bailey had departed after that, leaving them with an update that Christina instinctively knew wasn’t even half the truth and orders to stay where they were or else.
Derek had been in barely an hour later saying that he was heading home and did Meredith want to go with him. She had declined without giving him a reason but both Christina and Derek knew she had one and that it was the same reason Christina was still sitting here, despite having rounds at seven and the same reason Izzie was sleeping off the alcohol on George’s lap instead of in her own bed, and it was the same reason George was leaned up against the wall, eyes closed, exhausted and numb but still awake. Christina looked up at Derek from her spot on the lower bunk and raised one eyebrow in a silent question. With Izzie safely asleep and therefore unable to hear Derek answered quickly, briefly outlining the concussion and the seizures and the possibility of congestive heart failure and the overdose.
‘The what?’ George’s eyes flew open in shock and he quickly looked down to ensure Izzie was still sleeping.
‘The what? He what? The drug what?’ he whispered, stumbling through the disbelief in his usual inarticulate way making Christina want to cringe and clamp her hands over her ears.
‘He had really high levels of amitriptyline in his blood stream; we think he probably got his hands on some Endep or something. Seems a bit… un-Alex…though, I never really thought…’
Derek trailed off, not completing his sentence and Christina was left to wonder exactly what he thought because she knew she almost never thought about Alex in any context and she was fairly certain that Derek didn’t either.
That had been hours ago now and since being startled awake by Meredith’s snoring Christina couldn’t shake the gnawing feeling in her gut that this very really might not be all okay. They had survived ferryboat disasters and dead Mums and severed LVAD wires and toxic patients and secret wives. They had survived all of those things but maybe they had pushed the envelope too far with this one, maybe this was going to be the proverbial ‘whatever’ that finally broke the camel’s back. Shock registered in Christina’s awareness suddenly as she realised that she cared, she actually cared. She definitely cared about icy-blue Meredith and bathroom floor Izzie, but it was more than that. It wasn’t just that she cared whether Alex was going to be okay or not, she was, despite theories to the contrary, human after all, but she cared about the why and the how…she never cared about the why and the how.
Taking a deep breath, she pushed herself gently from the mattress and eased her feet back into her shoes. She opened the door just wide enough to squeeze her lithe frame through the opening, not wanting the sudden light to waken her sleeping companions, and stepped out into the deserted hall. She’d been the only sober one when the events unfolded and could remember jumping to her feet when Alex fled only to be stopped in her tracks by Addison Montgomery. She still couldn’t fathom exactly what it was that compelled her to stand to follow him but it was the same thing that was propelling her forward, towards the ICU, now.
It wasn’t hard to find Alex’s room but she nodded gratefully to the night nurse who pointed her in the right direction and murmured that Dr. Bailey had finally left about an hour ago but that Dr. Montgomery was still in there. She could see Addison through the glass, curled up in a chair beside Alex’s bed, her forehead resting on the mattress by Alex’s right hand. From her position Christina couldn’t determine whether Addison was asleep or awake but decided to go in anyway.
The metallic feet of the chair, missing two of the four plastic caps, scraped ever so slightly as Christina settled her weight into it. It was enough to wake Addison, whose head snapped up and eyes flew open, disorientation and confusion giving way to remembering and weariness.
‘Christina?’
‘The others are all sleeping - in the on-call room downstairs still - I couldn’t lay there any longer…’
Addison nodded in understanding and lapsed back into silence. Christina took a moment to take in Alex and the room and the machines and to piece it all together, to gather the meaning. She let out a long, slow breath, which caught Addison’s attention once more, and reached up to pull the chart out of its holder on the wall, scanning the details with a sense of surreal detachment. She could feel Addison’s eyes curiously watching her and raised her own to meet them.
‘You know, I don’t even know why I’m here; I can’t explain it, not even to myself. I guess I’ve never really had actual friends before and…’ she trailed off, unsure what to say next and was surprised by Addison’s response.
‘I don’t know why I’m here either, here in Seattle, here in this hospital and especially not here in this room. Right now I have absolutely no idea.’
Shocked by Addison’s frankness and her own overwhelming emotions Christina didn’t know how to reply and found herself reverting to doctor speak to ease her stress levels, she could do doctor speak, it was science and fact and it was exact and not confusing and terrifying and threatening to pull her apart.
‘So he’s triggered the vent a few times then? And the Diazepam’s stopped the seizures?’
Realisation and understanding shone brightly in Addison’s eyes and she hurried to play along.
‘Yes, no seizures since that second one just before twelve thirty so hopefully that’s it for those, he’s been triggering the vent more and more but his sats are still a bit low so they’re keeping him on it. They’ve been giving him regular activated charcoal doses, that’s why they’ve left the NG tube in. Heart rates still all over the place as you can tell,’ Addison jerked her head sideways towards the heart monitor beside her and Christina nodded her agreement and found herself contemplating the possible long term cardiac effects of amitriptyline overdose.
She fidgeted restlessly in her chair and stared absently at the irregular but still strangely hypnotic lines mapping out the arrhythmias plaguing Alex’s overwhelmed heart. Her fingers were itching for something to do, something to cut open, she didn’t know how to fix things unless she could cut them open and look at them.
‘It’s harder to deal with when you can’t cut it open and fix it and sew it back together isn’t it? I guess that’s the surgeon’s curse.’
Christina didn’t realise her anxiety was so obvious and reactively moved her hands under her thighs to stop them moving.
‘Yeah,’ she nodded, agreeing with Addison and once again finding herself shocked at the similarities in their thoughts.
‘There’s definitely no ‘quick fix’ for this one. I guess there’ll be some questions asked when he wakes up, though I pity the person who has to do the asking. I guess the lack of family means it’ll probably be left to Miranda.’ Christina felt herself relax at Addison’s words, finally feeling a semblance of comfort in the other woman’s presence.
‘Did you already know?’
Christina had voiced the question before she had even had time to process her intention and she looked up suddenly, worried that she had overstepped the boundary. To her relief, Addison looked lost in thought and not the least bit offended.
‘I mean, you were so calm when it happened, earlier at Joe’s, when Izzie, well…you know. It just didn’t seem to shock you and I know you two have been, uh…getting close? I just thought maybe you already knew.’
‘No, I had no idea. I mean, I’ve always thought there was something about him that couldn’t simply be explained by a crappy childhood and the desire to specialise in plastics, which often speaks for itself in my experience, but…no. I had no idea. I guess the lack of alcohol meant I was just able to hide it better than everyone else.’
‘I wasn’t drunk either,’ Christina retorted, indignance and a desire for Addison to know she wasn’t at Joe’s getting smashed when she had a shift the next morning causing her words to sound unnecessarily harsh.
‘I mean, I hadn’t even been there long, I’d only had one, the other’s were…well, you saw them but I wasn’t.’
‘No, I had kind of figured that out already, they way you stood up to go after him, in all honesty that nearly surprised me more than the wife news!’
‘Yeah, well, it surprised me too. I guess it comes back to why I’m sitting here right now, which I honestly still can’t answer.’
Addison nodded her understanding and Christina noted the absolute exhaustion that seemed to wash over her as she leaned back into her chair and closed her eyes.
‘You should really try and get some sleep. The door was open to the on-call room on this floor when I walked past and it was empty, I’m going to stay for a bit longer but you look like…well…,’ Christina grinned wryly, ‘don’t take this the wrong way but you look like crap!’
‘Well, I can’t say I usually look my best at four in the morning but yeah, I think I might do that. You’ll page me if there’s…well…you’ll page me?’
Christina nodded as Addison stood stiffly and bent to collect her bag.
‘Thanks for coming, I appreciated having someone to chat to and well…I won’t tell him if you don’t.’
Addison smiled sadly, conspiratorially and walked out the doorway without looking back.
The night nurse entered as Addison exited, intending to complete a round of obs. Christina offered to do it for her and the nurse agreed hesitantly and retreated back into the dimly lit corridor leaving Christina alone with Alex for the first time. Easily detaching as she efficiently completed the requirements, it was only once she had finished the task and resumed her position in the chair by Alex’s side that the desire for sleep took hold again. Lowering her head to the mattress in a manner that would have mirrored Addison’s earlier position had she still been there, Christina closed her eyes and let herself drift off to the comforting sounds of the cardiac monitor.
It couldn’t have even been twenty minutes later when Christina was startled awake by a strangled cry that she couldn’t quite place at first. Jumping up from the chair so quickly that it reared back precariously before she managed to grab hold of one arm and rest it firmly on four feet again, she took a moment to remind herself where she was and what the staccato high pitched beeping was trying to tell her.
‘Alex?’
Shocked and slightly panicked, her awareness still floating somewhere in sleep land, Christina was suddenly slammed back to reality. Alex’s eyes were open, translucent tears making tracks down the sides of his face and over his ears, soaking into the white pillow under his head, his hands were clawing at the sheets, bunching them up between white knuckled fingers and he was gagging desperately on the ventilator tube but Christina was distracted by the shrill piercing beep from the cardiac monitor alerting her to a more pressing issue.
‘Alex, it’s Christina. Alex, you need to calm down. I’ll get the tube out but you need to calm down first.’
The heart monitor continued beeping its warning as the nurse from earlier in the evening tore into the room. Alex’s eyes were flashing wildly, the terror and confusion in them almost a physical weight that Christina had never experienced before. She grabbed his forearm and attempted to stare him down.
‘Karev! Stop it. We’re taking it out? See?’
She disconnected the ventilator and looked across at the nurse for a confirming nod before settling her gaze back on Alex.
‘Okay, see, it’s coming out. Promise me you’re going to relax so I don’t have to sedate you and leave it in,’ she threatened, hoping her voice didn’t betray the authority and calmness she definitely wasn’t feeling.
‘Okay, deep breath out.’
Only once the tube was removed and some of the terror had dissipated from Alex dilated pupils did Christina allow herself to breath normally again. She had extubated hundreds of patients before but this; this was a whole new level of different. She secured an oxygen mask over his nose and mouth, being mindful of the NG tube, and willed him to calm down, words of no use to her in this situation. Consonants and vowels tangled together in her brain unable to connect in a way that made any sense at all, let alone a way that would offer comfort to Alex who was clearly in pain and dangerously tachycardic.
Breathe, Christina, this is cardio, this is your thing she willed herself and took a deep calming breath before turning her attention back to Alex and the nurse who was staring at her expectantly.
‘Should I page…’
‘No, just wait,’ Christina cut her off and settled on the edge of the bed in Alex’s line of sight.
‘Alex, look at me,’ she commanded forcefully but got no response.
‘Evilspawn, open your eyes and look at me’ she whisper screamed, finally getting his attention as his eyes unscrunched and blinked rapidly, hazy and unfocused but open and alive.
‘Okay, its okay. Now, if you don’t want me to page someone else you’re going to have to work with me a bit here. So, chest pain?”
Alex nodded slightly, took a sharp, shallow breath in and held it.
‘Alex, breathe, you need to try and keep breathing normally, you know all this. Just focus on breathing normally.’
She waited until he had resumed a somewhat regular breathing pattern before continuing.
‘Okay, so how bad out of ten?’
‘Eleven,’ Alex grunted, his voice raw and raspy even through the oxygen mask that still covered his nose and mouth.
‘Hah, typical,’ Christina scoffed. ‘Men! It’s never a seven or an eight, its always eleven, a stubbed toe is an eleven!’
The retort and the return to a familiar equilibrium in their relationship had the desired effect as the corners of Alex’s eyes creased ever so slightly into a small smile and the heart monitor stopped its frantic beeping and began to slow by degrees.
‘Okay, so maybe it’s a nine and a half,’ Alex bit back and Christina felt a weight lift off her shoulders.
‘Well, that’s nothing then, I hereby declare that you will live.’
Once again the words were out of her mouth before she had even had time to think about the implications of saying that last part to someone who had just overdosed. Berating herself harshly and attempting a desperate backtrack Christina took a step away and stammered that she was going to page the others and let them know he was awake.
‘No.’
Already half way towards the door she stopped in her tracks and turned back to the bed, feeling the nurse continue on her way past and out into the corridor.
‘Please don’t, not yet. I can’t…’ he trailed off and Christina could see the fear that was becoming all too uncomfortably familiar settle itself like a veil over his eyes.
‘Just please, not yet.’
‘Okay, I won’t, not yet. Why don’t you try to get some sleep and I will come…’
‘Christina wait, you don’t have to go. I mean, you can stay can’t you?’
Christina swallowed her rising discomfort with some difficulty and took a step back towards the bed.
‘Uh, sure, I can stay.’
Alex closed his eyes, his breathing finally beginning to even out, he had removed the oxygen mask while Christina’s back was turned so she clasped her had around it and moved to slip it back into place.
‘But that stays on,’ she ordered in a voice that Alex was either too tired or too apprehensive to argue with, a look of exhausted resignation in his eyes as he nodded his consent and the mask was re-secured.
‘Christina?’ came the muffled voice, fogging up the inside of the mask.
She looked up from where she was filling in details on his chart and raised an eyebrow in silent warning as Alex lifted the mask slightly to make comprehension of his quiet, breathy words a little easier.
‘I don’t really, well, some of it do but, I don’t remember everything. The bits I do remember aren’t that great and the last memory I have, well where I was…’
Alex’s right arm came across his chest, his fingers gripping tightly to the pectoral muscle above his heart, nails digging in, leaving small moon shaped indentations. Christina could hear his breathing hitch and shallow out once again, breaths coming in short, sharp gasps.
‘…Kinda makes me think I did something really stupid but I don’t know and, well if I did what I think I probably did then I don’t know what to do.’
Christina felt the walls of the ICU cubicle start to close in on her, suffocating her as her own heartbeat echoed loudly in the back of her throat, making her want to vomit or scream or laugh hysterically at the absurdity of Alex asking her what to do.
‘My heads killing me and it feels like someone is squeezing my heart as hard as they can and I can’t…think straight and…I can’t…breathe…and I don’t…know what to do…Christina, you always know…what to do…Please…tell me what to do.’
She could see his back arch slightly against the pain and the sorrow in his eyes and pleading in his quiet voice were Christina’s undoing as she felt an unfamiliar prickling burning in her eyes.
‘Uh, I’m sorry, I’ll just…’ Christina stuttered before tearing her eyes from the forlorn figure on the bed.
She blinked rapidly and felt two hot tears that mirrored Alex’s for pain and desperation scald tracks down her pale cheeks so fast that had one not landed on the back of her left hand she might never have believed that they had formed and fallen at all. She turned and fled, barely managing to stutter a goodbye on her way out.
‘I’m sorry Alex, I just can’t…’[
In her blind panic she almost collided with the nurse hurrying into the room as monitors began to shill their desperate warnings.
‘You’d better page a cardiologist,’ Christina stated blankly, ‘I think Dr. Cameron is on call,’ and continued walking towards the elevators, refusing to acknowledge the code blue alert reverberating at the nurses station or the continuous high pitched squeal signalling that Alex’s heart, like his spirit only hours previously, had simply given up.
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