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The energy in the conference room was notably different to usual. As JJ presented the case, Spencer had nothing to contribute. No fun facts, no statistics. No insights, no related cases, no off-topic tangents. Nothing. It was unnerving. But it wasn’t until he started humming quietly under his breath that he really drew the attention of the others. It was his most identifiable nervous stim, and he always went to great lengths to suppress it during briefings.
“Spencer, are you feeling alright?” asked Hotch, turning to properly look at his subordinate for the first time that day.
A visible sheen covered Spencer’s face. His shirt was slightly darkened in patches, and his entire frame trembled as if he had been doused in freezing water. His eyes looked glassy, distant, like he wasn’t completely there, and his unfocused gaze flickered lazily around the conference room.
“I’m- uh. I’m, it’s… it’s so fucking, uh, fucking… loud. It’s so loud. How, uh… I can’t… where…?”
Spencer spoke choppily, sentences rough and disjointed as if his brain were struggling to coordinate coherent speech. He seemed agitated, confused, as if he wasn’t entirely sure where he was. As he attempted to push himself up from his seat, his legs wobbled like a newborn foal’s, his gait unsteady and his destination unclear. When Spencer continued to babble to himself nonsensically, the team began to stand up themselves, eyeing Spencer up suspiciously. They were confused by his suddenly erratic behaviour and worrisome appearance. Their confusion was quickly interrupted, however, as Spencer’s eyes suddenly rolled up and flickered momentarily. His knees buckled painfully and he crumpled, sending his lanky frame toppling rapidly towards the ground. The collision happened before anyone could even register he was falling. His shoulder connected with the conference room floor with a nasty thud, limbs sprawling out haphazardly across the carpet. Spencer barely reacted to the impact, eyes still rolled into his head and completely glassy.
Hotch and JJ jumped into action immediately, rolling the unresponsive agent onto his side into the recovery position, tilting his chin up gently. His skin was clammy and blazing hot to the touch. He was absolutely burning up.
“Dave, call an ambulance.” Hotch demanded, and the older man immediately complied, scrambling to retrieve his mobile from his pocket.
“Spence, can you hear me?” JJ called loudly, fingers peppering against his sticky cheek in an attempt to rouse him. He could only lazily follow her with his eyes, humming uncomfortably under his breath.
“Okay. Okay, sweetheart. You’re okay. Just keep your eyes on me, Spence. Keep them open.”
“Mmm… don’ touch- ss… so cold…” he slurred out, flinching away from her gentle touch.
“Fuck, has he been using again?” Morgan muttered, hands wandering frantically over Spencer’s lithe form as he wondered what to do with them.
Spencer was basically dripping with sweat. His eyelids flickered and pupils roamed, breaths coming hot and heavy. Hotch reached down and pressed two fingers to his visibly pulsing carotid. His pulse was absolutely racing. They all knew what this looked like. They all knew what this could be.
“Prentiss, there’s a box of Narcan in my top drawer. Grab it, quick.” he barked over his shoulder.
Emily bolted as if her life depended on it. Perhaps Reid’s did. She returned in a matter of moments, already ripping open the cardboard and pulling out the white plastic dispenser.
She was crouched by Spencer’s side in an instant, sliding the long, thin nozzle into his left nostril in one swift motion. The sudden intrusion alarmed him enormously, and he became immediately combative in his confusion, writhing frantically against the plastic. Attempting desperately to bat away the nozzle, he mumbled incoherently, agitation skyrocketing as his resistances became almost primal. The nozzle slipped free, and Spencer rolled his head away languidly, like a toddler refusing his mother’s thumb. His breaths escaped his throat in rapid pants, face turning slowly crimson as his veins began to protrude against his forehead.
“Morgan, he’s confused. I need you to help me hold him still.” Hotch’s voice was tight, stressed. The creases in his brow were deep and cavernous.
“Reid, it’s okay. This’ll make you feel a lot better, buddy. You’ll feel some hands on your head and shoulders, but you’re safe. It’s just so we can give you some medicine, bud.”
“Nnnn…no… no, st’p… d’dn’t…! Ngh… mmm-!” Strong hands were placed on Spencer’s shoulders and forehead, providing an opening for Emily to swoop in closer. The sensation of the seemingly freezing hands against his feverish skin quickly proved to be too much for Spencer, who began to wail desperately, his sobs becoming increasingly breathless and increasingly difficult to listen to.
With significantly less resistance, Emily managed to slip the thin nozzle deep into Spencer’s nostril, depressing the trigger, allowing the clear substance to spray into his nose. Spencer began to hum anxiously, the sensation of the cool liquid nauseatingly uncomfortable. He gagged instinctively, and the hold against his head and shoulders was released.
“I… I w’ldn’t…! Nnnno… dr’gs… I- I need… n’d help… r’lly don’ feel good…”
JJ began carding her slender fingers through his sweaty curls, the way she knew he liked.
“Shh, Spence. It’s okay. The medics are on their way, sweetie. I really want to help you calm down though. Just copy my breathing- no, nonono Spence, keep those eyes open. Open your eyes for me. You can’t go to sleep right now, honey.” JJ’s voice was slowly rising in intensity as Spencer’s eyes began to roll back sporadically and eyelids started to flutter, eventually falling heavily shut.
“W-w’nna sleep, J’yje… ‘m t’red.” Spencer mumbled, eyes cracking open just barely at JJ’s frantic coercion. She smiled sadly in response, her own eyes starting to become glossy with tears.
“You can’t, sweetheart. Not right now. I need you to stay awake til the medics are here. Come on, you can do it. I’m right here. Keep your eyes on me, that’s it.”
The sound of heavy footsteps and rattling wheels barrelling towards the conference room drew everyone’s attention to the doorway. A set of paramedics, laden with heavy bags and dragging a gurney behind them, were herded urgently into the room by a crimson-faced, out-of-breath David. Discarding their bags, they immediately set to work evaluating their patient.
“What can you tell me about him? What happened?” asked the younger paramedic to nobody in particular, swishing her flaming red ponytail over her shoulder as she knelt down.
“His name is Doctor Spencer Reid. He’s 28. He’s been quiet all day, but we didn’t realise how bad he was until he started spouting nonsense and collapsed. He, um… he has a history of substance abuse. We thought it might have been an overdose, but the Narcan had no effect. He- he’s autistic, and has a severe beta lactam allergy.”
“Doctor Reid? Can you hear me?” she called loudly, trying to get a reaction from the barely conscious man. He could only groan weakly in response as she firmly rubbed her knuckles against his sternum.
“Alright, Doctor Reid. My name is Jess, and this is my partner Madeline. We’re paramedics. I’m going to unbutton your shirt, and stick some leads to your chest so we can keep tabs on your heart, alright? Maddy is going to pop an oxygen mask over your mouth and nose. All you need to do is relax and let the oxygen help you, honey. Nice deep breaths. We’re gonna take care of you.”
The second paramedic piped in, her voice lilting with a gentle Irish accent.
“I’m just starting an IV, Spencer, so we can get some meds into you and get you feeling better. Sharp scratch in 3, 2, 1-” Spencer did not react at all as the needle slid into his vein.
“That’s it. Good job, honey.”
Spencer could only blink languidly, writhing uncomfortably at the onslaught of sensation flowing through his body. Even if he still had the capacity to speak, the sensory overload overwhelming his addled brain had pushed him into a nonverbal state. Pulling open his purple button-up, the paramedics immediately noticed angry red patches spreading across Spencer’s fair skin, radiating out from his abdomen, now spreading up his throat.
The paramedics wasted no time in connecting Spencer to a variety of monitors, sharing a grave look upon interpreting the readings. His heart was fast, too fast, but his blood pressure was horribly low and getting worse. Most disturbing to the team, however, was the steadily declining number displayed on the pulse oximeter. The digit crept lower and lower between every sporadic, shallow wheeze Spencer managed to take in. The plastic of the oxygen mask pulled over his sweaty curls barely fogged. His eyelids continued to flicker, consciousness waning as he struggled to keep his footing on reality.
The paramedics quickly turned their attention to the blotchy red patches mottling Spencer’s bulging abdomen.
“Abdomen is super distended. That, and the rash…”
The older paramedic nodded gravely, before swiftly masking her unease and turning her attention back to her slowly ailing patient. She addressed him loudly, trying to provide an anchor point, something for his waning consciousness to latch onto.
“Okay, Spencer. You’re doing a great job, sweetie. I’m just going to have a quick feel of your tummy, alright? You’ll feel my hands touching your belly, lightly at first and then firmer. Pressure coming in 3, 2, 1-”
Jess pressed down lightly on Spencer’s lower right quadrant first, eliciting an agonised guttural scream. Spencer gasped desperately, breaths stilling in his chest, his face contorted in agony as he desperately tried to shrink away from the offending touch. An expression of grave concern passed over the paramedic’s features as she glanced at her coworker.
“Abdomen is so rigid. I think his appendix has burst. Probably hours ago, judging by the rash. Query sepsis. We need to get him stable so we can move.”
“His sats are still not good and getting worse, Jess. He’s not maintaining his airway independently. I don’t think we can move yet.”
“Try him on the bag valve first. See if you can get his numbers up.”
But no sooner had the younger paramedic sealed a large plastic mask attached to a silicone balloon over Spencer’s mouth and nose, squeezing it periodically to force oxygen into his struggling lungs, did the monitors begin to blare angrily. Spencer’s exhausted heart was giving up.
“He’s arresting. Starting chest compressions. Keep ventilating, please.”
The words struck horror into the hearts of the team. Panic wormed its way into the air, taking root in the throats of the waiting agents, breaths stilling in their chests as they watched the older paramedic fold her hands in the centre of Spencer’s chest and begin pumping furiously. They felt violently ill witnessing the way his chest caved in with each compression, ribs eventually giving way with a sickening crack. Jess did not let up even for a second, and Garcia averted her eyes with a sob at the ease with which his ribs now moved.
“Sats are still dropping. I’m going to intubate.” announced the second paramedic, still squeezing the bag and frowning at the still decreasing numbers on the pulse oximeter. The first only grunted an affirmation, sweat beading her brow from the exertion of the compressions.
Madeline suddenly turned to the team, huddled in the corner of the room, watching the macabre theatrics play out. Her voice was urgent.
“Can one of you come over here and take over ventilation for a moment? I need to prep the medications to intubate him.”
JJ was by her side in an instant, taking the silicone bag in her left hand, and using her right to firmly hold the large plastic mask against his face. Falling into the rhythm quickly, she began comforting Spencer under her breath, trying to ignore the way his body flopped like a ragdoll with every compression of his ribcage.
“Spence, they’re going to put you to sleep for a while, honey. Take control of your breathing. You’re safe, you’re doing so well. You’re just really sick right now, and need a bit of extra help. Just let yourself drift off, sweetheart. We’re all here with you.”
Producing a syringe of milky white medication, Madeline quickly connected it to the IV catheter in Spencer’s hand and began slowly depressing the plunger. “Propofol going in. This might burn a little, Spencer. That’s totally normal.” Her voice was kind, gentle, and the team silently appreciated the way she narrated the entire process to Spencer, despite his apparent unconsciousness.
Spencer’s still-rolled-up eyes suddenly fluttered closed as the drug took hold in his bloodstream. JJ continued to murmur quietly to him, her own eyes glassy with unshed tears.
“Alright, rocuronium going in.”
“W-what does that do? He’s already asleep, right?” babbled JJ, her wavering voice betraying her usual stoic mask.
“Rocuronium is a paralytic, sweetie. It’ll just relax his muscles so we can put the tube in without him fighting it. It’ll let us take over his breathing so his body can focus on getting better. It sounds scary, but it’s really common for us, and it’s the best thing for him right now.” she replied, depressing the plunger on the clear medication. JJ watched on in horror as Spencer’s previously shallow, wheezing breaths ceased completely, his chest now completely still. Madeline unceremoniously nudged JJ out of the way, and kneeled behind Spencer’s head, laying the intubation tray out next to it. Removing the bag valve mask, she quickly placed her hands on Spencer’s head, tilting it back firmly before pulling down on his jaw, encouraging it to fall open.
She reached for the metal laryngoscope, and clicked it open before inserting it into Spencer’s open mouth, sliding his tongue out of the way. Grabbing a thick plastic tube, she fed it down his throat little by little, until she was confident it was in the correct position. Inflating the attached balloon and reattaching the silicone bag from the ventilation mask, she resumed squeezing rhythmically, satisfied that Spencer’s chest was rising and falling sufficiently with each artificial breath she provided.
She turned to Jess, who was sweating profusely with exertion.
“Jess, let me take over compressions. You ventilate.” She nodded tightly, and the two quickly swapped positions, Madeline reaching for the defibrillator as she moved. She quickly slapped two sticky pads over his chest. A robotic voice sounded from the attached machine.
“Analysing rhythm. Abnormal rhythm detected. Shock advised. Stand clear.”
Spencer’s body jolted unnaturally and awkwardly as the shock passed through his body, tensing all over before falling weakly back to the ground. He looked positively lifeless.
“Shock delivered. Continue CPR.”
Madeline swiftly launched back into action, pumping on Spencer’s now distorted chest with a determined ferocity. Penelope choked back a gag watching his ribs begin to move independently from one another.
“Analysing heart rhythm. Normal rhythm detected.”
“Heart is stable for now. Let’s get him loaded.” Jess quickly turned her attention to the waiting agents. “We’ll need somebody to come and help- decide quickly.”
The paramedics quickly bundled Spencer’s pliable form onto the waiting gurney and secured him across the shoulders and waist with the attached straps. He looked like a puppet with its strings cut- limp, lifeless, and without purposeful movement. Jess continued to squeeze the ventilation bag rhythmically as Madeline began to guide the gurney out of the room urgently. JJ jogged desperately behind, waiting desperately to be assigned a task of use. Hotch, Derek, and Emily shared a look of immense guilt, while Penelope sobbed openly into the shoulder of Rossi’s blazer, soaking the material and darkening the shade. The air was oppressively heavy, a deafening silence falling over the conference room as the medics and JJ disappeared with a barely-alive Spencer.
The ride to the hospital was a complete blur. The only thing JJ could think about was squeezing the ventilation bag as perfectly as possible while Jess worked around them. She owed Spencer that much. She hadn’t even noticed anything was wrong with him.
Squeeze, release. Squeeze, release. That was all she had to cling onto.
The resus bay was a flurry of activity. Spencer was a popular patient. It made JJ feel sick- how life-or-death everything felt.
“Suspected septic shock secondary to a ruptured appendix. Abdomen is extremely distended and rigid. His team reported altered mental state prior to his collapse. Went into cardiac arrest on scene, CPR administered, shocked once to good effect. He’s now back in sinus rhythm. Intubated with propofol and rocuronium following cardiac arrest, sats back up and sitting at 95.” Temperature is at 104, BP 68/50 and dropping.”
“Right, let’s get him ready for the OR.”
JJ could only stand in shell-shocked silence as Spencer was once again whisked away past closed doors.
“What’s bothering you, Prentiss?”
“We jumped to conclusions so fast, Hotch. We assumed he was using so quickly. I can’t imagine how he felt hearing that. Hell, we loaded him up with Narcan without a second thought.”
“We couldn’t have known. Had he been overdosing and we’d not used the Narcan he’d be dead. It’s a good thing he didn’t need it.” Emily’s face suddenly twisted, her eyes saddening. Her voice was small, quiet- but dangerous.
“Don’t say that. Don’t say that, Hotch. Didn’t you- fucking hell - didn’t you see the way his ribs caved in? The tube down his throat? Shit, Aaron, he couldn’t even breathe on his own. How can you say that was a good thing?”
“We made a mistake. We betrayed Spencer’s trust. We’ll have a lot of work to do repairing this relationship, even if we thought we were doing what was right. I’m sorry I pressured you to give him the Narcan, Prentiss. I’ll take full responsibility.”
“I don’t know if it’ll be enough to take responsibility, Hotch. Spencer worked so hard for his sobriety. We acted like it was something he’d have just thrown away. He needed our help, and we gave him our doubt. He was scared and sick and we assumed he was high.” interjected JJ’s quiet, wavering voice. She had barely said a word since staggering out of the resus bay and into the waiting room several hours before, and even still did not make eye contact, her gaze haunted and distant. The room fell silent for several minutes, broken only by the gentle rap of a short blonde woman wearing scrubs.
“Family of Spencer Reid?”
“That’s us. I’m his medical proxy. You can speak freely in front of anyone here.”
“Very well. It’s a pleasure to meet you all, but I’m sorry it has to be in this situation. My name is Doctor Rebecca McGuire. I am the emergency surgeon who operated on Doctor Reid this afternoon. Doctor Reid’s surgery went well, and he is now recovering in the ICU. What we discovered was an acute and severe case of appendicitis, which worsened when his inflamed appendix burst, spilling that infection into his abdominal cavity. It is highly likely his appendix burst hours before his collapse, which allowed the infection time to spread through his bloodstream. As a result he is now experiencing septic shock. This is a very dangerous condition, agents, and Doctor Reid is not yet out of the woods. We performed an open appendectomy and cleaned out his abdomen in an effort to stop the infection from spreading further or worsening, but he remains in a critical condition. He is currently in a medically-induced coma to allow his body to fight the infection and heal, and he will remain on the ventilator for the next few days at least. He has several broken ribs caused by the CPR, and will be on heavy-duty antibiotics and fluids until the infection clears. We plan to lighten his sedation in a few days and see how he’s coping, but it is likely he will be quite uncomfortable with the pain from the surgery and broken ribs, as well as the infection. I understand he has a strict no-narcotics order, but we can revisit that request if needed considering his recent cardiac event.”
Penelope’s eyes welled up with fresh tears. “W-what do you mean by that? He can’t have narcotics. He just can’t.”
Doctor McGuire gave a sympathetic smile.
“I understand. We will do our best to manage Doctor Reid’s pain levels with non-narcotic pain relief. However, if he is experiencing significant amounts of pain and distress while so vulnerable, he is risking another cardiac event. It may then be in our best interests to consider stronger pain relief. As I say, it’s a situation we will revisit only if necessary. You are very welcome to visit him if you like, but no more than two at a time, please. To be completely frank, agents, he does not look good right now, and he is very unwell. As well as the very prominent ventilator tube, he’s attached to a lot of different and scary-looking pieces of equipment. All are medically necessary, and are allowing us to provide Doctor Reid with the best possible care. Please know that we are always very happy to answer any questions you may have about the setup in the ICU. If the first two visitors would like to follow me?”
Emily and Hotch shared a nervous glance, while Rossi gestured to indicate for somebody else to go first. Penelope and JJ stepped forward, tentatively following the doctor down the hallway towards the ICU.
The doctor had not exaggerated. Spencer really did not look good.
He was laid flat on his back, tangled curls splayed messily across the stark white pillow. The thick plastic ventilator tube spilled from his slightly parted lips, connected to a large noisy machine that hissed and clicked with every artificial breath it forced into his lungs. The tube was secured in place by a blue plastic tube holder that partially obscured the feverish sheen across his cheeks, a sheen still very visible across his forehead and brow. A large cannula was inserted into the side of his neck, held in place by a large plastic dressing. Several medications were attached to the IV pump, including one marked ‘continuous sedation’. A drainage tube protruded from underneath his gown, collecting fluid from his abdomen, and another bag collected golden urine from his catheter. Spencer himself looked completely gaunt. The bags under his eyes were deep and dark, and his brow was slightly furrowed even in unconsciousness. His pallor was grey and cool, his usually pale complexion even starker under the harsh fluorescent lighting. It was unnerving to see him so still and frail, even his most basic bodily functions being performed by a machine.
Penelope immediately took up residence on the stool near Spencer’s bedside and grasped his limp hand in hers, stroking her thumb across his prominent knuckles. Tears glistened in her eyes, spilling over onto her blushed cheeks.
“Oh, my sweet baby genius. I’m so sorry you felt so yucky and didn’t think you could tell us. I so wish you had, sweetpea. But you’re gonna fight really hard, right, and be awake and talking to us and feeling better in no time. I just know you are.”
JJ grasped his other hand and reached her other up to his hair, carding her fingers through his tousled hair.
“Hi Spence. It’s JJ. You’ve been so brave, sweetheart. So strong on your own. But it’s time to let us take care of you now. You don’t have to hold up the world, Spence. We want to hold it with you. I feel sad you didn’t tell us you felt so nasty. I feel sad I couldn’t take you home and make you soup and force antibiotics down your throat and play with your hair. I feel so sad I didn’t realise you were so sick. I’m so sorry, honey. You need to fight, Spence, and you need to get better. We’re gonna get you off this tube and nice and strong in no time at all. And I will never, ever let you suffer alone again. Fight hard, Spence. Kick this infection’s ass.”
And though she knew it was illogical, JJ would have told anyone how she felt Spencer squeeze her hand back.
After three nights in the coma, Spencer’s sedation had been lightened, and the doctors were expecting him to rouse. In preparation for his awakening, soft limb holders had been secured around his wrists, preventing him from pulling any tubes in the inevitable panic that was to come. The team sat vigil, all watching for the moment Spencer would emerge from his medicated haze. Emily was sitting by his bedside, reading War and Peace aloud, when his face began to scrunch and his fingers twitched slightly. He let out a low moan around the tube, and his head rolled slightly in discomfort. The team were immediately on their feet, the book abandoned and the call button jabbed.
“Hi, Spence. You’re okay, honey. You’re just waking up from a long sleep. The team are all here, there’s no rush, you just take your time.” JJ soothed, immediately taking his hand in hers, caressing it gently.
Spencer seemed to be regaining more control over his body, and he began to rub his fingers against the waffled blanket, trying to control some of the incoming sensations that were returning to his body. His low humming only intensified, and he began to ricochet his head against the pillow as much as he could, the action only igniting the pain in his ribs. His wrists tugged against their restraints, his face screwing up in frustration. He could not move them to remove the clinical tasting tube between his lips. He needed it out. He needed it out .
“Spence, listen to my voice. It’s JJ. You’re in the ICU. You’ve been really sick, honey. I know this is a lot and you’re really overstimulated but we can’t remove any of the equipment just yet. Dave is going to turn out the lights-” she shot David a pleading glance. “And Emily is going to pet your hair, just the way you like it, and I’m going to squeeze your right hand nice and firm, and I want you to really focus on that sensation, okay?”
Spencer’s eyes flickered properly open now the room was dim. The look in his eyes was nothing short of pitiful. He glanced panickedly down at the breathing tube, and JJ shot him a sad smile.
“I’m sorry, sweetie, but the tube can’t come out yet. The doctors need to check if your breathing is okay first. I know it feels nasty, but you need to let it breathe for you. Don’t fight against it. That’s it, Spence. Focus on my squeeze. Keep your eyes on my face. The doctor is on her way. You’ve been so brave. Henry can’t wait to see you. He’s been asking for you constantly.”
After a few more moments of gentle rambling, a tall brunette woman in a white coat came bustling through the door. Her face quickly brightened when she realised why she had been summoned.
“Hello, Doctor Reid. It’s a pleasure to properly meet you. My name is Doctor Charlotte Walsh. I’m an ICU consultant. I’m so pleased to see you awake. Now, I know this is a lot for you, so I want to check your breathing and see if we can get you off the breathing tube. I’m going to reduce the ventilator support and keep an eye on your breathing to see whether you’re ready to breathe independently. It will feel a little bit different and you’ll have to do a little more work, but it’s completely safe. If you’re not yet ready, I’ll increase the support again, so you have nothing to worry about. Can you signal to me that you understand?”
Spencer gave a defined blink and pleading glance. His stimming increased in intensity- he was nervous. Emily and JJ continued their soothing stimulation, attempting to keep him calm in a situation that could easily tip him over the edge.
“Let’s get you sitting up. This might be a little uncomfortable, you have a few broken ribs, but I’ll take it nice and slow.” murmured Doctor Walsh, reaching for the bed controls. Spencer whimpered slightly as the bed was raised, face crinkled with slight discomfort, but did not signal for her to stop.
“Alright, great job. I’m going to change the settings now. The tube will stay in, but you’ll be able to draw your own breaths. You’re doing so well, Doctor Reid.”
Spencer’s eyes widened slightly as the support he had been leaning on suddenly disappeared. He instinctively held his breath.
“No, come on, Spence. Deep breath in, honey. You can do it.” cooed JJ, exaggerating her own breaths in an effort to get him to mimic.
Spencer’s first breath was a noisy, strained gasp that surprised even himself. But he quickly fell into a natural rhythm, his breathing taking less conscious effort with every new breath. Doctor Walsh seemed impressed.
“That’s perfect, Spencer. You’re doing so well. I’m going to take the tube out now. Agents, you don’t have to watch this part if you’d prefer not to.” she stated, laying out the necessary equipment over Spencer’s lap. The waiting team shook their heads.
“We’ll be fine. He needs us now more than ever.” admitted Hotch quietly, from just out of Spencer’s field of vision.
Spencer’s eyes widened slightly in surprise. He had assumed Hotch didn’t want to see him. That he thought he was still an addict. His apprehension must have shown, because in the next moment, Hotch was by his side, rubbing his leg underneath the blanket repetitively.
“I’m sorry Spencer. I’m so sorry. We’ll talk later. Let’s get this tube out, buddy. You’re doing so well.”
“I’m just going to deflate the balloon, Doctor Reid. You don’t need to do anything special except give me a nice big cough when I say so.”
Spencer was very evidently trying to compartmentalise enough that he could follow instructions. His gaze was full of focus, like he was manually processing every word.
“Alright, the balloon is deflated. I just need to give your mouth a quick suction to clear any gunk, okay? This is not very comfy, but it will be quick. Just a little pass on each side. That’s all.”
The suction catheter gurgled loudly as it cleared Spencer’s airway of any obstructions. He flinched visibly at the sensation, free hand now weakly thumping against the mattress.
“That’s it, all done. Tube is coming out now. Big cough in 3, 2, 1-”
With one swift motion and a hacking cough from Spencer, the tube slid free, and was placed in a waiting cardboard dish.
“Well done, Spencer. That’s all done. I’m going to pop a regular oxygen cannula on you just for a little while to make sure your levels stay nice and high. You’ve done a fabulous job. I’ll come visit you again later for some more checks, but I want to give you a chance to regulate first. Lovely to see you awake.”
She hooked a clear plastic nasal cannula over Spencer’s ears, tucking the prongs into his nostrils, before turning the dial to start the flow and gathering up the extubation waste to throw away. With her job done, she turned on her heel, acknowledging the room full of visitors with a curt nod before disappearing.
With the doctor gone, the team finally had a moment to themselves with the newly-conscious Spencer.
“Hey kiddo. How are you feeling?” murmured Rossi, his voice soft and fatherly.
Spencer’s voice came out weak and raspy, still raw from the breathing tube.
“Like I’ve been run over. W-what happened?” he croaked, licking his lips weakly to try and moisten them. Penelope wordlessly spooned him some ice chips, pressing them against his lips.
“Appendicitis, kid. Your appendix burst and you collapsed. Apparently it’d burst hours before then. Septic shock. You had emergency surgery to clean out your abdomen.” Derek muttered, shaking his head sadly at Spencer.
“Then, uh, why does my chest hurt?” he whispered, voice barely audible.
A heavy silence fell over the room. It was JJ who broke it, her voice tinged with sympathy.
“You went into cardiac arrest, honey. They gave you CPR in the conference room. Few broken ribs, but you should heal up nicely. Why didn’t you tell us?”
“Didn’t want you to worry. Thought it was just… lactose cramps. Thought it might go away.”
“Spencer, you can always tell us if you feel unwell, sweetie. We wish you’d said something this time. You gave us a really big scare.” interjected Penelope, her voice warm, safe. Comforting.
“Are you feeling okay now, Spencer?” asked Emily, her voice laced with a tenderness the others did not hear often.
Spencer was clearly flagging. Between the overstimulation and the residual sedation, he looked utterly wiped.
“M okay. Sore. Pain. Tired. Sorry, words going. But- but need to say. Hotch, Derek. Em. ‘m not mad.”
Hotch looked up in surprise.
“Spencer, I betrayed your trust. We assumed so easily you were using. We know how important your sobriety is to you. We never want to believe you would be using. We were just so worried about you. You gave us such a fright, we just did what we thought was right. I’m so sorry.” Hotch’s voice cracked slightly at the final word. Spencer’s eyes glistened with forgiveness.
“The symptoms are… same. You did, uh, what you thought… right. Sorry. Can’t talk. Voice going. Not mad. Love you.” he managed to slur out, the pull of sleep too strong to resist.
“We love you too Spencer. Sleep, now. We’ll be here. Always.”