all that i have: a hollanov fan fiction (by cami)
CHAPTER FOUR: fighter.
read chapter one here! / chapter two / chapter three
major tw: mention of CPR, depiction of hospitalization/ICU
"what have we got?"
"professional hockey player, male, late 20's, unknown medical history. sudden cardiac arrest during a game 30 minutes ago. CPR initiated immediately, shocked twice. got a pulse back, thready, arrested again en route. pulseless v-tach, epi given, shocked a third time. got him back again. still not breathing spontaneously. intubated with an 8mm en route and have been bagging him since the arrest. 2 large bore catheters placed in left and right AC. vitals are all unstable." one of the medics rattles off to the doctor in the trauma bay.
"alright. i want full labs, lactate, troponin, BNP, blood gases. 3 view chest rads, continuous ECG. i want a foley once he's stable. somebody page cardio. get him on the vent now. start cooling measures, they're gonna want TTM on him. what's our pressure?"
"last pressure reading at 68 over 44. sinus arrhythmia, 130 beats per minute. pulse is still thready."
"get a norepinephrine drip ready. hold on fluids. get me an art line kit."
the emergency department breaks into an uproar of demands. monitors chirping. the humming of a ventilator. ilya's chest rises and falls mechanically. medications are pushed. lines attached. numbers are shouted out as they change.
his pressure starts increasing, rhythm still irregular but decreasing in rate. they drop his temperature on purpose. he's sedated to keep him from shivering.
48 to 72 hours. that's how long they're giving him on the ventilator before they start weaning his sedation, seeing if he wakes up. assessing neurologic status. the next few hours are critical. keep his brain oxygenated, organs perfusing, lactate down.
finally, a social worker addresses the elephant in the room. "does this young man have any family? emergency contacts?"
"his name is ilya. rozanov." one of the trainers, anthony, answers. he had been involved in the arrest from the start, and knew ilya fairly well. "family is all in russia. i believe both parents are deceased. i've stayed in touch with his coach, he's going to be bringing paperwork on emergency contacts as soon as possible. it could be a few hours. i've got a name: svetlana vetrova. address is listed in boston. he's getting me her number. second emergency contact is coach. he'll be here. we can't find any information on a power of attorney or any wishes outside of full code status." in all honesty, he hates having to discuss the logistics of this. he just wants answers. for ilya to be alert. stable.
the conversation carries on for another ten minutes: working out the fine details. questions about visitation. who can receive updates. who is making decisions in life or death situations. it's a lot for anthony. this was the last conversation he expected to be having tonight. he checks in with the doctors one more time before calling coach with everything he knows.
"hey, jankowski. it's anthony hayes. i'm here with him. he's still with us. kid is a fighter. we lost him again in the ambulance, but he's back." his voice shakes as he speaks. he pulls the receiver away for just a minute to take a breath. losing him the first time was horrifying. losing him the second time ripped him in half. "yeah, i just wanted to give you an update. we don't have a lot of information yet, they're starting tests. he's not breathing on his own, still throwing arrhythmias so he's going on a vent. they said 48 to 72 hours, and then they can assess brain and organ damage. cardiology is looking at him right now and getting him admitted. i'm sure they'll tell you all of this when you get here. you and this svetlana girl are the only people approved for visitation right now. i already said goodbye." like it was final. emotion finally creeps in. "god, i hope he pulls through. kid is what, 26? fuck. okay, i'll meet you when you get here. i'm guessing the game was cancelled? okay. that's not surprising. i'll see you soon, then."
anthony waits in the lobby, head tucked in between his knees. this was what he was trained for, but it was his first arrest. something he'd never forget, and never wanted to see again. he'd take all the blood, vomit and open fractures over this any day.
somewhere behind closed doors, ilya is still fighting.
trigger warning: description of ventilator, dissociation
svetlana keeps her promise. she stays.
it's been just over 48 hours when they wean his sedation for the first time. they explain that he may or may not become fully aware. that he'll be disoriented, probably upset, but it's unlikely that he will remember any of it. not long-term. sveta says she understands. she just wants to be there with him, no matter how things go. she promised she would be there when he opened his eyes, and she intended to keep that promise. she can't stand the thought of him being alone.
it happens slower than she expects. five minutes pass. ten. no change. at fifteen minutes, his eyes begin to flutter. a low groan escapes him. "Всё в порядке, Илья. Я здесь." (it's all right, ilya. i'm here.) his eyes open at that, but they don't track. he sees a vague, blurry image of a hospital room. he can hear machines humming and beeping around him.
"that's good, ilya. that's really good." one of the respiratory therapists, elena, smiles warmly. she takes both of his hands gently in her own and gives them a squeeze. "can you feel that, ilya? can you nod, or give me a squeeze back?"
ilya hears the words, but they don't make sense yet. he can tell she's asking him a question. he blinks slowly. fuck, his chest hurts. he does his best to tell her. he tries to speak, but nothing more than another groan comes out.
"okay, ilya. i hear you. i need you to squeeze my hands if you can."
the words process better this time. slow, but better. he squeezes both eyes closed, like he really has to concentrate to make any sort of movement. both hands twitch faintly inside the nurse's. his mind wanders a bit. not full thoughts, just ideas. what the hell had happened to him?
"open your eyes again for me." he does. "good job. you're doing really great." she turns her attention to svetlana. "these are all good signs that he's neurologically intact. we're going to decrease it a little bit more. this doesn't guarantee he's going to get the tube out right now. these are all just tests. we'll adjust him as he needs."
svetlana nods at that. she holds onto that phrase like it was a promise. good signs. "Ты отлично справляешься, Илья. Оставайся с нами." (you're doing a great job, ilya. stay with us.)
the next 2 hours feel eternal. respiratory therapists, nurses, the hospitalist are all in and out. they assess him. give him short breaks. eventually he's nodding consistently, moving his legs a little. he feels like he's in a haze. he's following commands, but still not really understanding where he is, or why. it's scary.
he can't explain the shift that happens in the room. irritation takes over. his patience runs as dry as his chapped lips that hurt to move. he musters every bit of strength left in him and moves both hands to clutch at the tube, giving it a weak tug. something moves in his throat, and it makes him gag. that's when the panic sets in.
"no, ilya. you need to keep that in. that's helping you breathe, okay? you can't take that out."
ilya doesn't care. he wants it out. it's uncomfortable, and now he's hyper-aware of it. his eyes burn with tears as he fights against the staff, trying desperately to raise his hands back up.
"no. you're not ready yet. it's okay, we've got you. we're going to give you something to help you relax, okay? we'll try this again later." elena explains. "go ahead and bolus him."
no. he's tired of not having control. he wants to wake up and find out what the fuck is going on. what are they trying again later? why is he here? why—
he's back out again in just moments.
"we're going to give him a little break. we need to do what's called a spontaneous breathing trial before we can remove the tube. respiratory will be back in a couple of hours and we'll see if we can get him extubated."
svetlana nods, but she's still a little confused. he was waking up, he wanted the tube out, why not just take the tube out? but she had to trust the staff.
she takes a walk to the cafeteria, paces the halls of the main campus. she watches a mother in a wheelchair heading out with her newborn baby. an older gentleman being assisted with a gait belt. a girl probably her age with wet eyes and a bald head. fuck, she hated hospitals. she heads into a gift shop and finds a small teddy bear. she stares at it for a while with a smile on her face. should she? he might find it funny. fuck it. she buys it.
the two hours pass faster than she expected. they come back in and start the weaning process again. it's similar at first. he wakes up. he's a little more irritable, hands stuck in soft restraints against the bed so he can't pull the tube again, but he complies.
"we're going to turn the settings down on the machine. i'm gonna go ahead and have you take a deep breath for me."
ilya moves his lungs on his own terms for the first time. it feels... good, and bad at the same time. he's glad to have that control back. but his ribs are killing him. there's a faint crack every time he takes a deep breath. a noise only he can hear, but it drives him crazy.
after what feels like forever, it's time. they keep his hands in restraints for the time being. "big, deep breath in for me and then you're going to cough. one, two, three—"
eyes squeeze shut as he lurches forward and coughs. the relief is almost instant. he's coughing and gagging, his throat still burns a little, but there's no more tube. his mouth is suctioned out. his hands are released. the tube is replaced with a nasal cannula. it tickles, but it's much less invasive. holy fuck, he did it.
"Я так горжусь тобой, Илюшка. Я здесь, рядом с тобой. Я тебя очень люблю." (I am so proud of you, Ilyushka. I am here, right beside you. I love you so much.) svetlana squeezes his fingers and smiles at him. she raises his hand to kiss the back of it, letting out a content sigh. "Как ты себя чувствуешь, любовь моя? Тебе больно?" (How do you feel, my love? Are you in pain?)
ilya opens his mouth to speak, but nothing comes out. he licks his lips. his mouth has never felt so dry. finally, after a minute or so, "Да. Это больно." (Yes. It hurts.)
svetlana's heart cracks a little bit. she shouldn't be surprised. he's been intubated, not allowed to move for 72 hours. he's been poked and prodded countless times. multiple ribs were broken or bruised from the CPR. of course he was going to hurt. "Всё в порядке. Можете сказать нам, что болит?" (everything is fine. can you tell us what hurts?)
"Моя грудь." (my chest.) no hesitation.
she turns her attention back to the nurse for just a moment. "he says his chest hurts."
the nurse nods at that. "that's okay. that's normal. your body has been through a lot. just try to relax for me. i'm going to let doctor know that you're awake. he's probably going to have some questions for you. just do your best. we'll get you something for the pain. can you nod if you understand me?" she doesn't want him to wear his voice out. he's still coughing every minute or two.
ilya nods. he gives sveta's hand another small squeeze. everything takes extra effort right now. he feels like he's moving through molasses. the moment the nurse leaves, ilya turns his head slowly toward svetlana. her eyes are wet. she's so glad he's awake. so sad that he's hurting. and so fucking scared to see his reaction to finding out what really happened. and as if on cue, he asks.
"Ты упал в обморок во время игры." (you fainted during a game.) she answers briefly. she doesn't want to overwhelm him. he needed to focus on resting and getting stronger before this conversation happened. "Теперь ты в безопасности." (now you are safe.)
it didn't explain everything. he figures it must have been pretty bad if he had the tube in. he wants to ask for more details, but he's too tired. staying awake was enough of a struggle right now. "okay." ilya closes his eyes, grimacing as he goes to take a deep breath. he's asleep for what feels like thirty seconds before svetlana is gently shaking him awake again. "Ваш врач здесь." (your doctor is here.)
"hi there. my name is doctor bishop." she's surprisingly young for a hospitalist, very short and blonde hair tied up in a ponytail. she stops just shy of the foot of the bed and speaks loud and clear. "can i have your name?"
"ilya." he coughs on the last syllable. "rozanov."
"nice to meet you, ilya. i'm glad to see you awake and talking. how are you feeling?"
"bad. chest hurts, and... dizzy."
bishop glances up at his vitals. sinus rhythm. slightly tachy. oxygen is decent given the circumstances. "that's what they told me. i can give you some medicine to help with that. i just wanted to chat first, see if you were able to answer some questions."
they go over them. just verbal at first: can you count to ten? what is your job? which team do you play for? where are we right now? the last one he gets wrong. he says they're in boston. she corrects him gently: montreal.
montreal. why does that ring a bell in his mind? it bothers him. he continues following commands, finishes out the questions, but montreal is stuck in his mind. what about that city was so familiar? there's an emotional weight there. montreal... hockey? the metros. he hated the metros. was that all it was? no... jane. montreal jane. shane. fuck. how could he have forgotten shane? he needed to text him. now. svetlana said this happened during a game? so he knew. shane knew. oh, god, he was probably freaking out.
"sveta?" the word sounds weaker than he wants it to. he'd finally gotten those pain meds, and it was making him fade out again. "my phone?"
she looks at him for a moment. "Илья, ты только что проснулся. Зачем тебе телефон?" (ilya, you just woke up. why do you need your phone?)
"please one text."
sveta hesitates before reaching into a plastic bag with his personal belongings. she finds it quickly. graciously, it still has juice. 10%.
[ 𝒔𝒎𝒔 📲 jane ] : 14:10 : just woke up. when can i see you? soon please
he hands the phone lazily back to svetlana. she doesn't mean to look. but he left it open. jane. of course. montreal jane.
That’s difficult to say…I’ve been very blessed to be pretty lucky.
If it’s something that’s had long-term affects, I think it’d have to be watching my grandmother die. She was in the ICU because she had had a really bad fall (she was about 95 years old) and we stayed with her until they had to take her breathing tube out. She couldn’t keep breathing on her own and so she passed away. She was very old and had had a very awesome life, but it still affected me. I absolutely hate ICUs now. I guess this is a pretty simple experience, but it really affected me and it makes me really upset to think about.
