Note: My knowledge of medical terminology, symptoms, treatments, procedures, etc. is limited to what I could find out on the web and episodes of "ER" and "Emergency". I'm not a doctor, I don't play one on TV and I apologize if I've violated the Hippocratic Oath in any way, shape or form. My intentions are good; I meant to do no harm.

Chapter 4

After the helicopter landed, Jed, Zoey and the Secret Service detail were met by hospital security and escorted to the Presidential suite. Waiting for them was a middle-aged man who was not much taller than the President.

"Mr. President, I’m Dr. Elliott Freeman, Chief of Staff here at NYU-Mt. Sinai." He extended his hand and Jed quickly took it. "The suite has been prepared for your stay and if there’s anything that you need, feel free to ask."

"Thank you, Doctor. I’d like you to meet my daughter, Zoey, and the head of our detail, Ron Butterfield."

Freeman acknowledged each one and gestured for Jed and Zoey to be seated on one of the couches.

"How’s my wife?" Jed asked.

"She’s out of surgery and in recovery. She’ll be brought up to the suite in a few hours."

"Can I see her?"

"Of course." He turned to Ron. "Agent Butterfield, the area has been secured by members of Mrs. Bartlet’s detail if you’d like to check it out." Jed nodded to him and Ron slipped out of the room. Freeman continued. "Dr. Emily Collins was the trauma surgeon on duty when your wife was brought in. She’s one of the best. She’ll meet you in the recovery room and explain exactly the nature and extent of your wife’s injuries."

"Were there other people hurt? What are their conditions?"

"A passenger in your wife’s car - I assume it was one of her assistants - was injured. He suffered minor cuts and bruises, a mild concussion and a sprained knee. He was treated and released. The driver of the armored car died a half hour ago. His partner is still in critical but stable condition," Freeman said.

Ron stepped back into the room and gave a brief nod to both the President and Dr. Freeman. "Mr. President," Freeman began, "if you’re ready, we can head down to recovery." He stood and Jed and Zoey joined him. They followed Ron to the elevator.

Dr. Freeman led Jed and Zoey to the recovery room. Outside the room was a young woman in hospital scrubs whose dark hair was pulled into a ponytail. She was talking to several nurses who surrounded her. As they approached, they could hear her giving out instructions.

"I want vitals every half hour and PO2 levels every hours. If her pulse ox levels remain stable, we’ll try extubating tomorrow. If anything changes, I am to be paged immediately. If her pressure spikes, be sure to notify Dr. Lucas."

"What do we tell people who ask about her?" one of the nurses asked.

"Nothing. She’s a patient and her privacy is to be respected just like any other patient. Remember, our first priority is to our patients, not the public. Is that clear?" With affirmative responses, she dismissed the nursing staff.

Dr. Freeman approached the young woman from behind and whispered in her ear. She quickly turned around and came face to face with the President of the United States. If she was surprised or awed by him, she didn’t show it, only a mask of complete professionalism.

Jed, however, was taken slightly aback. The woman standing before him didn’t look much older than Zoey. But he could see that she was confident in her abilities and from what he heard, she was a very capable young woman.

Dr. Freeman did the introductions. "Mr. President, Miss Bartlet, I’d like you to meet Dr. Emily Collins. Dr. Collins, this is President Josiah Bartlet and his daughter, Zoey."

Emily extended her hand, which Jed shook. "Mr. President, it’s a pleasure to meet you, although I wish it were under more pleasant circumstances."

"Thank you. Doctor, I’d appreciate it if you could tell me about my wife’s condition," he said anxiously.

"Of course," Emily replied. Glancing over at Zoey’s drawn features, she asked softly, "Sir, would prefer if we spoke privately?"

"I’m okay," Zoey said. "I want to know what’s happening."

"Besides," Jed said, "you’ll save me the trouble of having to explain something I know absolutely nothing about."

Emily nodded. Taking in a deep breath, she looked at both of them directly. "Mrs. Bartlet was brought in suffering from a broken left wrist an a fractured left ankle. She also had a ruptured spleen, internal bleeding, several broken ribs, one of which punctured and collapsed her lung, causing a pneumothorax. We inserted a chest tube to inflate the lung. We also intubated her and put her on a respirator to assist her breathing until we could repair the damage to the lung.

"We removed her spleen and stopped the bleeding. The damage to her lung was not a serious as we initially thought and we were able to repair the damage. Right now, she’s still intubated and on the respirator, but as her pulse ox levels stabilize, we’ll prepare to extubate her, hopefully by tomorrow." She hesitated, unsure of how to continue.

Jed helped her out. "I’m guessing there’s more. Doctor, one thing you’ll learn about me and that is I don’t believe in beating around the bush. If you have something to say, just say it."

"Very well," Emily said. "There was a head injury. The CAT scan revealed evidence of a skull fracture along the left parietal lobe." She gestured to the left side of her head. "The trauma caused some swelling in the brain. We’re hoping that meds and time will bring the swelling down. We also found evidence of an epidural hematoma - that’s bleeding on the surface between the brain and her skull. We think and it’s our hope that it will stop on its own. Our chief neurosurgeon, Dr. David Lucas, has been brought in and he’s monitoring her case as well."

"And if it doesn’t?" Jed asked.

"We’ll have to do what’s called a trepanation."

"What’s that?"

"It’s when the neurosurgeon would take a small drill to the area where the bleeding is and he would drain the excess blood."

"Why can’t you do that now?" Zoey asked.

"The accident was a tremendous assault on your mother’s body. Her condition, though stable, was critical. We determined that it was too great a risk to do another major surgery without allowing her time to get stronger. We’re keeping a close eye on her condition, and if we have to, we’ll go ahead with the surgery."

"Will there be any brain damage?" Jed asked.

"We can’t say for sure. If the swelling goes down in the next 24 hours and the bleeding stops, I’d say there shouldn’t be any brain damage. Beyond that, there may be some damage. Whether it would be temporary or permanent, I really couldn’t say. Dr. Lucas would be the best person to speak to about that."

Zoey shuddered involuntarily. Emily noticed that the young woman had unconsciously latched onto her father’s hand and was digging her fingers into his palm. He didn’t seem to notice. He was staring intently at the doctor, as if to size her up. Emily sensed this, so she spoke up. "Mr. President, I realize that you know absolutely nothing about me or my qualifications. I was the trauma surgeon on duty at the time your wife was admitted. I, along with this staff, have provided the best possible medical care for her. It has been our privilege to do so. However, I realize that you may want to have physicians and medical personnel that you know and trust to assume Mrs. Bartlet’s care. I am more than happy to step aside. Also, if you’d prefer, we can have her transferred to Bethesda Naval Hospital or George Washington University Hospital as soon as her condition stabilizes."

Jed nodded and sighed. Oddly enough, he had the same thoughts but wasn’t sure if he should voice them. He was grateful that the young doctor had been sensitive enough to address his concerns and humble enough not to allow ego to get in the way of what was best for Abby. He smiled gratefully at the doctor.

"I appreciate your honesty, Dr. Collins. Whatever the circumstances of your being here, I am indebted to you. You were here, you did your job and my wife is alive because of your efforts. And as far as I’m concerned, you, your team and this hospital are the best things for her right now. I am confident that you will continue to act in her best interests."

"Thank you, Mr. President," Emily replied. She opened the door to the recovery room and led the two of them inside. She watched as Jed made his way to Abby’s bedside. She knew that they needed some time to take everything in. "I’ll let you have some time alone with her. I’ll be right outside the door if you need anything." She saw him nod and closed the door behind her.







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