Chapter 70 Forty-Eight Hours
"He has broken ribs at the left side." Elena's voice was steady despite her hands shaking. "Derek, I need the IV started. Now."
Derek moved immediately, finding a vein in Pierce's right arm while Elena cut away the rest of his clothing.
The damage was worse than she'd feared. There were purple bruising spread across his left ribcage, the bones visibly shown. A deep gash ran from his temple to his jaw, still bleeding. His breathing was shallow.
"Pierce, stay with me." Elena pressed her hand to his face. "I need you conscious. Can you hear me?"
His eyes opened, unfocused. "Elena..."
"I'm here. I'm going to fix this but I need you to stay awake." She turned to Marcus. "Hold pressure on that head wound while I deal with his ribs."
Marcus moved to Pierce's head, pressing gauze against the gash, the blood soaked through immediately.
Elena's hands moved feeling along Pierce's ribs, three broken, maybe four were broken. One was dangerously close to his lung.
"This is going to hurt," she warned.
Elena applied pressure, feeling for any fragments that might puncture the lung. Pierce's body went rigid, a strangled sound escaping his throat.
"I know, I know it hurts." Elena's voice cracked but her hands stayed steady. "But we're almost done."
She worked quickly, checking each rib, ensuring none had shifted into dangerous positions. When she was satisfied, she grabbed the wrapping materials.
"Derek, help me sit him up."
Together they lifted Pierce into a sitting position and he gasped, his face going white.
"Breathe," Elena commanded. "Slow, shallow breaths."
She began wrapping his ribs, working from bottom to top, applying firm pressure with each pass. The wrap would stabilize the breaks, prevent further damage.
Pierce's breathing was ragged, each inhale clearly painful.
"We're almost done," Elena murmured, securing the wrap. "Derek, lay him back down, carefully."
They eased Pierce back onto the bed, his eyes had closed again.
"Pierce!" Elena tapped his face. "Stay with me."
His eyes fluttered open. "I'm still here."
"Good." Elena moved to his head. "Marcus, let me see."
Marcus lifted the gauze. Blood welled immediately from the deep gash running along Pierce's temple and cheek. The wound was jagged, dirty with rubbish.
"I need to clean this before I can stitch." Elena grabbed saline and gauze. "This is going to sting."
She cleaned the wound, clearing away dust and rubbish. Pierce's jaw tightened but he didn't make a sound.
Elena threaded a needle with hands that wanted to shake but didn't. She'd done this hundreds of times in the ER. This was no different, except it was Pierce and if she failed. She avoided thinking about it and focused on the work.
She started stitching. Pierce's eyes were closed but his breathing told her he was conscious, feeling every pull of the thread through his skin.
"Talk to me," Elena said, needing to keep him conscious. "What happened in there?"
"There was an explosion." Pierce's voice was rough. "The third floor... collapsed."
Elena finished the last stitch and cut the thread. "Thirty-two stitches. You're going to have a scar."
"Add it... to the collection."
Elena cleaned the wound again, applied antibiotic ointment, bandaged it carefully, then she moved to check his pupils.
"Follow my finger." She moved her hand slowly. Pierce's eyes tracked it but not smoothly. One pupil was slightly larger than the other.
"He has a concussion," Elena said. "It's moderate to severe. Derek, where's the IV?"
"It's running." He said.
Elena checked Pierce's other injuries, he had cuts and bruises covering his arms and back, nothing as serious as the ribs and head wound but painful still.
"Your lung sounds are low on the left," Elena said, listening with her stethoscope. "But no puncture."
Pierce coughed, then gasped at the pain it caused.
"Don't cough if you can help it." Elena adjusted his position slightly. "The ribs need to stay still to heal."
She worked through the night, monitoring his vitals, adjusting his pain medication, checking for signs of internal bleeding or lung collapse. Every thirty minutes she woke him to check his consciousness level.
Marcus watched from the corner, his face drawn with guilt. Derek assisted wherever needed, following Elena's directions without question.
Around 2 AM, Pierce spiked a fever.
"Derek, get the ice packs." Elena's voice was sharp. "Now."
She checked the head wound, no signs of infection yet. But the fever meant his body was fighting something.
"Pierce, where else are you hurt?" Elena demanded. "Did you hit your abdomen? Your back?"
"I doon't... remember." His voice was fading.
Elena examined him more thoroughly, pressing on his abdomen, his back, looking for signs of internal injury she might have missed.
There she saw a deep bruise on his lower back, kidney area. She pressed gently and Pierce groaned.
"It could possibly be a kidney bruise." Elena looked at Derek. "We need to monitor his urine output. Any blood means we're going to the hospital whether he likes it or not."
She spent the next hour managing the fever with ice packs and medication, watching for any sign his condition was deteriorating.
By 4 AM, the fever had broke.
Pierce's breathing evened out, his vitals stabilizing.
Elena sagged into the chair beside the bed, her hands finally shaking now that the emergency was over.
Marcus approached quietly. "You saved his life."
"I stabilized him." Elena's voice was hollow. "He's not out of danger yet. The next forty-eight hours are critical."
"But he's alive."
"For now." Elena looked at Pierce's sleeping face, the bandage covering half of it, the bruising already spreading. "He needs rest and weeks of it."
"He won't stay down that long," Marcus said.
"He doesn't have a choice." Elena's voice turned to sharp. "Those ribs need six weeks minimum to heal. The concussion needs monitoring. If he tries to move too soon, if those ribs shift-"
"I know." Marcus held up his hands. "I'll make sure he follows your orders."
Dawn light filtered through the windows. Elena had been working for eight hours straight, her scrubs covered in Pierce's blood, her body exhausted, but he was alive.
Derek appeared with coffee. "You should rest."
"I can't leave him."
"I'll watch him. Wake you if anything changes." Derek's voice was gentle. "You did good, Doc. But you need to sleep or you won't be any use to him."
Elena knew he was right but she couldn't make herself move. She just sat there, holding Pierce's hand, watching his chest rise and fall.
"Elena." Pierce's voice was barely a whisper.
Her eyes flew to his face. He was looking at her, his eyes clearer than they'd been all night.
"You're awake," she breathed.
"You saved me." Pierce's thumb brushed over her knuckles. "Again."
"You scared the hell out of me." Elena's voice cracked. "When your GPS stopped moving, when the radio went silent...I thought..."
"I know." Pierce squeezed her hand weakly. "I'm sorry."
"Don't apologize. Just.." Elena stopped, the emotion was choking her. "Just don't die on me."
"I'm not planning on it." Pierce's eyes were already closing again. "I promised... I'd come back."
"And you did." Elena brushed his hair back from his forehead, careful of the stitches. "Now you need to rest. Let your body heal."
"Stay?" Pierce's voice was fading.
"I'm not going anywhere." Elena settled into the chair, her hand still holding his. "Sleep. I'll be right here."
Pierce's breathing evened out into sleep.
Elena sat watching him as morning light grew stronger, her body exhausted, her mind still racing, her heart finally believing what her doctor's training had been telling her all night.
He was going to live.
The injuries were serious but not fatal. With rest and care, he'd recover.
Elena let out a shaky breath and finally let herself cry, relief and fear and exhaustion all pouring out in silent tears.
Marcus touched her shoulder gently. "Go sleep. I'll watch him."
This time, Elena nodded. She stood on trembling legs, pressed a kiss to Pierce's forehead, and stumbled toward the stairs.
She made it to the bedroom before collapsing onto the bed, still in her blood-stained scrubs, too exhausted to change.
He was alive.
That was all that mattered.
Everything else could wait.