Page 148 of Captivated

“He’s experiencing difficulty.” Dr. Ramirez spoke in a gentle tone. “That part of the chest wall actually moves in the opposite direction when he tries to take a breath. It’s called paradoxical movement, and it can make breathing very inefficient and painful.”

Nate was suddenly numb.

“We’ll do a CT scan, looking for internal bleeding and air escaping from his lung due to so many fractures.”

“Oh God.” Robert’s eyes widened. “Is he in pain?”

“Yes, but we’re managing it closely. We’ve given him strong pain medications, and depending on how he responds, we might use an epidural or other targeted treatments to keep him comfortable. Managing his pain is crucial. It allows him to take deeper breaths, which helps prevent complications.”

Robert’s sharp intake of breath sounded so loud in the small room. “What kinds of complications?”

“The biggest concern is pneumonia. When someone’s in too much pain to breathe deeply or cough properly, fluid and mucus can build up in the lungs. So we’re doing something calledpulmonary hygiene. That’s a series of treatments that help clear his lungs and keep his airways open.”

“What treatments are we talking about?” Sol demanded.

“We’re using oxygen. We may use something called BiPAP. That’s a type of non-invasive ventilation used to help patients breathe easier. This helps to keep the airways open. We may need to use a ventilator for a time, to help him breathe while the trauma heals.” He paused when Robert made a stricken sound. “I know, it’s a lot to take in.”

“Keep going, doctor. I need to hear all this.”

Teague placed his hand on Robert’s back.

“We’re suctioning to remove secretions from his airways. We’re also encouraging breathing exercises with a device called an incentive spirometer, and we’ll help position him to ease his breathing.”

Robert dropped onto a chair, his shoulders sagging. “Will he need surgery?”

Dr. Ramirez bit his lip. “Possibly. In some cases, we perform a procedure called surgical rib fixation, where we use plates or devices to stabilize the broken ribs. It can reduce the time he needs in the ICU and help prevent longer-term complications.”

Robert’s Adam’s apple bobbed sharply. “How long will he be in the hospital?”

“It’s hard to say exactly, but it will likely be a while. He’ll spend time in the ICU, especially if he needs a ventilator. Recovery can take weeks or even months. Some people continue to have trouble breathing for some time after leaving the hospital. Once’s he’s started to recover, he’ll need to perform some breathing exercises.”

Robert’s breathing grew shallow. “Will he… I mean… could this be fatal?”

Dr. Ramirez’s grave expression sent Nate’s heart plummeting.

“Flail chest is very serious, and yes, it can be life-threatening. But Toby is getting aggressive treatment, and we’re doing everything we can. Right now, he’s fighting.” He smiled. “And he’s holding on.” He patted Robert on the arm. “All you can do right now is just be there for him. When he’s awake and stable enough, your support will mean everything. So once you’ve seen him, get some rest if you can. We’ll keep you informed every step of the way. If anything changes, I’ll let you know immediately.”

Robert swallowed once more. “Thank you, Dr. Ramirez. Please… just do whatever it takes.”

Dr. Ramirez smiled. “We will. He’s in good hands.” He gestured to the door. “Let me take you to them.”

They followed him out of the small room. Nate froze in the middle of the hallway, torn between two options.

Robert touched his arm briefly. “You and Sol go see Zeeb. Teague will come with me.” His skin was the color of ash, and he seemed to have aged ten years in the last five minutes.

Nate’s throat tightened. “If you’re sure.” Then Sol’s strong arm was around his shoulders, and Nate leaned into him.

A nurse emerged from one of the trauma rooms, and Dr. Ramirez addressed her. “Nurse Paton, these two gentlemen are here to see Mr. Nolan.”

“Certainly, doctor.” She pushed the door open, and Nate followed her into the room, pulling up short when he caught sight of the bed and its occupant.

The white overhead light cast a sterile glow over the hospital room, but it did nothing to soften the harsh reality of seeing Zeeb like this.

Except it didn’t look like Zeeb.

His hair was matted with sweat, his forehead streaked with the faintest residue of dried blood. His face was bruised, his left eye nearly swollen shut, the dark purple discoloration creeping across his cheek like ink spilled on paper. The sharp angles of hisface were softened now by the swelling. His lips were chapped, the skin stretched tight.

Even in sleep, there was no peace in his expression.

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