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It started as a twinge in his chest. It was nothing, just an innocuous little ache beneath his breastbone. For Buck, it was easy to write it off as lingering adrenaline from the surprise of the party or maybe a pulled muscle from his recertification test. As Athena led him into the living room, he quickly shoved all thoughts of it aside and reveled in the pure joy of the moment. It was a good day, the best he’d had in months, and Buck wasn’t going to spend a second of it dwelling on anything negative.
The pain, however, wouldn’t be ignored so easily. He managed to hide the winces as his team pulled in for a series of back slapping hugs, but the sharp pangs were still there. Still, Buck forced himself to act normal as he mingled with the guests. He fawned over Christopher, gave Hen and Karen his stamp of approval on their sperm donor, and convinced himself to eat at least one piece of Chim and Maddie’s cake. Even as he laughed and shared cheerful small talk, Buck couldn’t help but rub at his chest. His thoughts drifted briefly to the Advil in his car and the gel ice packs he kept in his freezer, but he snapped out of it when Bobby called his name and waved him over to the patio.
“They’re sending me the paperwork in the morning and you will officially be back.” Bobby announced proudly. “How’s it feel?”
“Ah, I’m just glad it’s over. You know, I…” Buck had to pause for a moment, massaging his chest and taking another breath. “I hated not being with you guys.”
“Yeah, we missed you too.” Said Bobby sincerely. “It’ll be nice to have the whole team back together.”
“Thanks Cap. And I don’t just mean for the party and the cakes, umm…” Buck trailed off, gathering his words. “Thank you for being there. For the surgeries and rehabs. I umm…I know I wasn’t always the easiest person to be around.” Buck admitted with an uncharacteristically shy smile. Bobby rolled his eyes in mock annoyance.
“Oh my God…Nah, you weren’t that bad.” He assured, patting Buck lightly on the shoulder.
“You should…tell that to…my ex…girlfriend…sorry.” The coughing came out of nowhere and Buck could barely get the words out.
“Hey, she just wasn’t the right fit. You’ll find someone new.” Bobby kept his tone neutral, but his brows furrowed in concern. The crease only deepened when Buck’s coughs didn’t taper off.
“Sorry…I…” By this point Buck was starting to sway as the force of the coughs threatened his balance. Why couldn’t he get enough air?
“You okay?” This time, Bobby didn’t try to hide his concern. The other guests were starting to notice and make their way over.
“Yeah I…” He couldn’t get the rest out. The world was spinning around him as the pain flared sharply and his lungs fought to take in a full breath. As someone familiar with the sensation of choking, Buck could only describe the feeling as a fiery blockage of his airways. If he could just get it out…
Suddenly, something warm and wet trickled past his lips and into his hands and he paused to stare in absolute horror at the red stains on his fingers.
“Buck?” Bobby stepped forward, reaching out to steady him. There was a moment of horrible clarity in which he realized that something was terribly wrong. He locked eyes with Bobby, wanting to tell him that, but instead of words, all he could manage was a wet gurgle as blood seemed to pour from his mouth. And then he was falling…falling…
“Buck!” Bobby shouted, racing forward and catching him just in time to prevent his head from smashing into the patio tiles.
“Call 911!” Someone shouted.
“What happened?” Eddie asked, sliding to his knees next to Bobby. In the background, they could hear a wave of shocked whispers and Michael herding the children away.
“I don’t know. We were talking and he just started coughing. I think his chest hurt too.”
“He was holding his chest all night.” Maddie added, tears streaming down her face as she and Chimney ran over.
“Let’s get him on his side!” Ordered Chim, already preparing to roll him.
“Jesus, there’s a lot here.” Eddie muttered as he swept his finger through Buck’s mouth, trying to clear his airway. Buck didn’t resist as he laid there, blue eyes staring glassily ahead. While Eddie was working, Buck’s body jerked, and another torrent of blood bubbled up.
“Fingers aren’t going to cut it, we need suction.” Hen cut in.
“Where the hell is it coming from?” Asked Bobby, feeling terrifyingly useless. Eddie and Chim shared a look.
“Pulmonary embolism?” Eddie suggested, his eyes shining with fear.
“He has all the symptoms. But this long after the surgery?” Chim questioned. He dropped the subject when Buck grunted softly.
“Buck? Can you hear me, kid?” Bobby asked as he rubbed his back gently. Buck whimpered slightly and tried to curl in on himself.
“No, buddy, you gotta stay on your side, okay?” Eddie held him in place with a firm hand. “I know it hurts, but the ambulance will be here soon.” Buck’s only response was a choked moan, followed by a series of harsh coughs. Blood spewed from his lips and he gagged as it pooled in his throat.
“It’s obstructing his airway.” Chim said tersely. “Help me get him up!” Together, Bobby and Chim hauled Buck’s limp body into a sitting position while Eddie pounded on his back.
“Hang on, Buck. Just stay with us.” On the fifth blow, Buck spat out a large, dark red clump of congealed blood onto his shirt.
“Oh my God…” Hen breathed.
“His lips are starting to turn blue.” Maddie observed. “We need to get him on oxygen now. Where the hell’s the ambulance?”
“ETA two minutes.” Athena replied after she consulted with the operator on the phone.
“Hear that, Buckaroo? Two more minutes. Just hang in there.” Urged Chim, but he doubted Buck heard him. His eyes were open, barely, but he they weren’t looking at anything in particular. He seemed solely focused on dragging in each shallow, wheezing breath. They tried not to cringe at the way the rattled through his lungs. By the time the paramedics arrived, Buck was unconscious.
“What do we got?” One of them, Andrews, Bobby recalled, asked as he joined them.
“Male, twenty-eight, five months post-op after a crushed left tib/fib. Presenting with angina, dyspnea, hemoptysis, and progressing cyanosis.” Eddie rattled of quickly. “We think it’s a PE.” Andrews nodded and quickly examined Buck.
“I think you’re right. Tim,” he instructed, addressing his partner, “get him on high flow O2 now, his sats are dropping fast. Then prep the suction.” In short order, Buck was transferred to the backboard, and, from there, the gurney.
“I’m riding with him.” Bobby asserted, climbing in back as they loaded Buck into the ambulance.
“I figured, Captain.” To the others, he added, “We’re taking him to LA General.” Chim and Maddie were already racing toward their cars. Eddie started for his truck, his blood-soaked hands already fumbling for his keys, when he remembered Christopher in the other room.
“Go.” Eddie whirled to see Michael standing behind him, holding out a wet washcloth. “I got your boy. Same goes for you, Hen. Buck needs you now.” Eddie accepted the cloth with a grateful nod before he and Hen ran out of the room.
After an interminable wait, a doctor finally came out to address them. They were all on their feet in an instant, eyes shining with worry.
“Mr. Buckley is stable. You were right, it was a pulmonary embolism, likely related to his injury. Its not common to develop clots like he did so long after surgery, but it’s not unheard of.” He explained.
“I’m sorry, clots? As in more than one?” Maddie asked, wringing her hands nervously.
“There was the one in his lung, but we also found two more in his leg. We’re treating them as we speak and he’s responding well.”
“I don’t understand. He just had got a clean bill of health a week ago.” Said Chim incredulously. Eddie sighed and ran a hand over his stubble.
“Dehydration can increase the risk of clots. We all know how hard Buck was training for his recertification. He probably pushed himself too hard.”
“And it’s not like he’d mention that he was in pain.” Hen added grimly. “After everything he’s been through, it probably didn’t even register.”
“So, what does this mean going forward?” Bobby asked.
“Mr. Buckley’s been transferred out of the ICU and into a regular room. We’ll keep here at least another day and evaluate him for risk of future clots. Right now, we have him anti-coagulants and he may need to stay on them long-term. There are, of course, risks associated with blood thinners, as I’m sure you know. Right now, we just need to wait and see.” They were silent a beat, letting the implications sink in.
“Is he awake? Can we see him?” Maddie asked, breaking the tension.
“Of course. If you’ll follow me?”
“Hey, there he is.” Bobby greeted softly as they filed in Buck’s room. Buck smiled and, though it was a feeble imitation of his usual grin, it went a long way in soothing their frazzled nerves.
“Hi guys.” He croaked. Even with all of the blood cleaned off of him, he still awful. He was strikingly pale, accentuating the dark circles around his eyes. His lips had thankfully lost their blue tinge, but it was hard to ignore the nasal cannula resting just above them.
“How are you feeling?” Asked Maddie as she sat down and took his hand in hers.
“Umm, really tired. My chest is pretty sore.”
“Yeah, that’s to be expected, buddy. You had one rough night.” Eddie gave his arm a light squeeze.
“I don’t really remember most of it.” Buck admitted. “I didn’t ruin the party, did I?” They all grimaced collectively.
“Hon, the guest of honor vomited blood and collapsed. Nobody really felt like celebrating after that.” Hen explained gently.
“Did I scare the kids? Oh God, did I stain anything? Athena’s gonna-“
“Be very happy that you’re okay.” Bobby interjected. “She’s worried, Buck, not mad. All of us were. And as for the kids, they’re fine. They’re with Michael.” Buck nodded, still looking a little guilty.
“I’m sorry about all this.” He gestured vaguely at the room. “I didn’t mean to…ya know…” Chim snorted.
“We all know you didn’t do this on purpose, Buckaroo. There’s no way you could’ve predicted it.”
“But, you could’ve told us that you were experiencing leg and chest pains.” Maddie added pointedly. “However,” she relented, “that is a conversation for when you’re feeling a little better. For now, we’re just glad you’re okay.”
“Is…is this going to affect my recertification?” Asked Buck worriedly.
“We don’t know yet.” Bobby answered honestly. “They’ll know more in a day or so, so let’s cross that bridge when we get there, alright?” Buck nodded, closing his eyes and massaging his forehead.
“Your head bothering you?” Eddie frowned, noting the creases in his friend’s face and the way he was squinting, even in the dim light.
“It’s nothing.” Buck waved it off, even as the motion made him wince.
“Buck.” Bobby cocked a challenging eyebrow and broke out his best, no nonsense tone. “You do remember what just happened as a result of you not being honest about your symptoms, right?” Buck glanced down sheepishly.
“I’ve got a bit of a headache.” He confessed quietly.
“Uh huh. Scale of one to ten?” Eddie questioned.
“Ummm, four?”
“Which, after converting from the Evan Buckley Pain Scale to a normal person’s interpretation of pain, that’s sitting at, what? A six?” Chim quipped.
“At least.” Agreed Hen.
“I’ll go talk to your nurse about getting you something for that.” Maddie was out of the room before Buck could even protest.
“I think it’s time we let you get some rest.” Eddie suggested, adjusting the bed so he could lay down comfortably. “You’ve had a long day and some sleep will do you good.” It didn’t escape Buck’s notice that Eddie was plumping the pillows and arranging the blankets in much the same way as he did for Christopher. Bobby must’ve noticed too because he chuckled softly to himself as he snapped off the light.
“Sleep well, kiddo. We’ll come check on you tomorrow.”
“If you’re good, we might even smuggle in some cake.” Chim whispered conspiratorially.
“Only if you get me one as cool as the one from your party.” Buck mumbled, already drifting off to sleep.