Burden Of Guilt
Part Four
By Kristen
kdarganin@hotmail.com

JC/PB/MG friendship

Last eppy seen "May Day" takes place afterwards with a few minor adjustments.

DISCLAIMOR: I don't own them, please don't sue.

ARCHIVE: Anywhere as long as my name is attached and you tell me.

NOTES: This story would not be possible with the help of my supper editors Lyss and Megan. They have provided me with a wealth of help and suggestions. Special thanks for her wonderful medical knowledge to Debbie. Also, to Sharon, Debbie, Cathy and to everyone who has supported me.

SUMMARY: Things don't go as planned on the way to Atlanta.

Carter was exhausted. The process of taking such small, useless breaths was driving him crazy. The pain had not tampered off and his ears were filled with the sounds of the pounding storm that seemed to reverb inside the broken vehicle. The other two doctors were not talking and he wasn't up to starting any new conversations. He knew Benton would get even more pissed if he continued to speak. It was so odd to see him so worried. He hadn't seen that look since that horrible night in the OR. In a way he was glad that he wasn't alone.

Peter was getting restless. There was no where for them to go and the sound of Carter's labored breathing was making him anxious. The man was so stubborn. When help arrived, he would just convince the younger man to accept some form of pain medication. Peter's thoughts were interrupted when he heard the distant sound of a siren. Benton hit his head on the ceiling as he stood up upon hearing an emergency vehicle.

Mark was closest to the back door. He had some difficulty in opening the lever in his rush. He swung the door open in order to direct the EMTs, or whomever was sent to aid them. Mark nearly fell while climbing down to the ground. He turned to Benton who was following right behind him.

"Stay with Carter; I'll advise them what's going on." Mark left leaving Peter no choice, but to remain with their patient.

Peter had been Carter's doctor; he wanted to inform them of his condition. He knew Mark was just as competent, but he felt that he was in charge of Carter's care. He eased his way back and wanted to prepare him to be transported. He kneeled down and noticed him breathing faster then he had been during the entire ordeal.

"Its going to be fine, man. Help's here," Benton told the panicked doctor. His face was sweating and Carter locked him with that same face of fear. This was an expression he did not want to see again. It was hard to reassure his former student when he was just as worried.

Peter grabbed his hand again for the third time that night. He held it in his own giving Carter strength and courage. "I will be there the entire time, Carter. Nothing will be done without my knowledge." Peter knew he shouldn't be promising things that he didn't have any control over, but help was here and Carter needed to calm down.

Mark returned with two paramedics, one red headed woman and some burly guy. Peter didn't bother looking at their name tags, he just began to bark out orders to regain some control over the situation.

"We have a male Caucasian, 29, who was struck my a vehicle. He has a concussion with two lapses of consciousness. He complains of dizziness and blurred vision. He has two broken ribs on the right side with a probable sternal fracture. There are no symptoms of a flail chest..."

"Peter, I already went over his state," Mark said from outside the van.

Benton got out of the way of the emt's, and stood next to Mark as the two paramedics carried a backboard into the van. They shifted Carter onto the board after they put a cervical collar on. They were asking him a series of routine questions. Carter's replies were inaudible over the noise of him being transferred into the ambulance. Benton hopped into the back following the gurney and Mark went to the front to sit in the passenger seat of the ambulance.

The lady paramedic began to start a large bore IV then placed a blood pressure cuff around Carter's arm. The other medic was cutting off Mark's old T-shirt. For the first time in a well-lit area, Peter could see the large bruises that marred him. They were a dark shade of purple and covered his chest and dotted his side. There were some scrapes that he hadn't noticed before. Peter wondered what else he wasn't aware of.

The male attendant was placing an oxygen mask over Carter's face while radioing the hospital with his patient's vitals. "We have a male, 29, victim of a hit and run. Pulse 125, BP 140 over 90. His resps are 25 a minute and shallow on the right side. Our ETA is 15 to 20." The EMT turned to Benton.

"How long ago was the accident?"

"About three hours ago," Benton replied.

"Any dementia or hallucinations?"

"No," was Benton's tired answer.

"What's his name?" The male attendant asked.

Benton was annoyed by these mundane questions, but he answered him. "Carter." Peter looked at the guy. "John, Carter."

The female medic began to place cardiac leads on his chest. She spoke to him in one of those placating tones. "Now, Mr. Carter, we know you're a little distressed. Just try to slow down your breathing."

Carter closed his eyes willing his lungs to take slower, deeper breaths. He could hear the heart monitor increasing with his rate of breathing. His blood pressure was probably going through the roof, but he couldn't turn his head to look with the neck collar on.

The female spoke again. "Looks like you sustained a chest injury and I know you're in a lot of pain. We'll have you in the hospital in no time and then the doctors can..."

Peter cut her off, his voice irritated. "He's a doctor. He knows the routine and he knows the tests. You don't have to talk to him like a patient," Benton said while checking the blood pressure reading. It was up to 145 over 90.

"Please, ah, I presume Dr..."

"Dr. Benton," Peter finished for her.

"Well, Dr. Benton, please don't touch the instruments. And remember he is a patient today. Alright?" The woman went back to monitoring Carter's vitals.

Peter Benton sat there. Quietly, and very fed up. The night had all the ingredients of a very bad dream. Now it had erupted into an unstoppable living nightmare. He just prayed it would end very shortly.

The ride to the hospital was worse then enduring the silence of the van. The ambulance kept running over bumps in the road and a grimace or a groan rewarded each jerk. All Carter wanted to do was sleep. He wanted to forget this night, to forget this month. He wanted all his problems to disappear. In his heart he knew this was impossible, but he would start tonight. The confrontation with Benton had made it perfectly clear how close he was to the edge.

He had been walking a fine line for months now. He had started with extra doses of his pain medication, but in the craziness of the ER he had done the unthinkable. He couldn't believe he started injecting himself when there was a sudden onset of pain. Not only did he endanger patients' lives, but also he put his friends in danger. If they had not felt the need to send him to rehab, then Dr. Benton might not have been put in a dangerous situation. It didn't even occur to him that he saved the man's life. Carter rode out the tenacious ride, and could feel the ambulance slow down as they apparently arrived at their destination.

He was unloaded and wheeled into [the- don't need this] some foreign ER. There was a flurry of activity; people shouting and poking him. They were asking him questions again. The same ones that he had been asked all night. He answered each one; tired already of more unwanted attention. 

Mark and Peter followed the gurney into the ER. They were instructed to wait outside and they informed the staff that they were doctors. One of the nurses told them that trauma two was cramped as it was, and only one of them could come and observe. Peter was in the room before the nurse could finish giving him instructions on protocol.

Peter wasn't gloved or gowned, but he stood back, keeping at least one promise. He watched all the things that were being done, noting that the team was running efficiently. He heard many shouts of orders.

The man running the trauma was busy checking vitals. He yelled to one of the nurse's, " I want a chest film, x-rays on each lower quadrant, and get the room ready for a head CT."

Benton was told that Dr. West was very good by the paramedics, and his command of a trauma was impressive as he continued to examine Carter ruling out various things. Dr. West was prodding Carter's ribs when he heard him ask John some questions.

"Mr. Carter, have you had some recent surgery? I have noted some surgical scars on your abdomen." Dr. West leaned over for the answer, but Carter's reply was muffled by his oxygen mask.

Peter walked over to the doctor ignoring the warning stares of the nurse.

"I'm Dr. Benton, and I was the surgeon who performed on Dr. Carter." Peter placed some emphasis on the words Doctor Carter.

Dr. West looked over at the man who answered for his patient. He looked very serious and had some obvious concern for a colleague. He wasn't going to allow hospital politics dictate how to properly care for his patient.

"Dr. Benton, by all means please update me on Dr. Carter's, history. It will be helpful when examining the X-rays," Dr. West asked in all sincerity.

Peter glanced over at John knowing the man didn't want to think about the recent past. He had no choice, and he knew that as a doctor he understood the medical reasons for speaking for him.

"Dr. Carter was stabbed twice in his lower back about three months ago. I repaired the kidney; there was no renal damage. I performed a colostomy and he hasn't had any complications since," Benton told the other doctor in his most professional manner.

"Thank you, Dr. Benton. I'll look for any scar tissues from his previous injury and order an MRI." Dr. West ordered the test as one of the nurses returned with Carter's chest films and x-rays.

Both Peter and the other doctor looked at the chest film noting the sternal fracture. Carter's ribs were indeed broken on the right side, but he wasn't suffering from a flail chest. That meant no respiratory complications. Peter sighed with relief when the other x-rays confirmed that there was no internal bleeding. This meant no ex-lap, no additional surgery.

Dr. West was pleased, and turned to one of the other residents. "Alright, let's take a look at that concussion with a head CT. Hopeful we can rule out a subdural hematoma and any other head trauma." Dr. West turned to Carter as he was being wheeled to x-ray.

"You may know that the way your pupils reacted that I think you have a medium concussion, but I'm pretty sure that there's no addition problems. Once that is confirmed in a few minutes I'll hook you up with a small dose of morphine IV, okay?"

"No!" was Carter's garbled, but vehement answer.

"Excuse me, Dr. Carter?" Dr. West asked.

The nurses stopped wheeling the gurney so the conversation could continue. Carter clumsily took off his mask in order to make his point clear. "I don't want any pain medication. No narcotics. I'm within my right to refuse," he told the bewildered doctor. Carter looked around despite the pain it caused in his head until he located Peter. He locked eyes with him, so his friend would back up his request.

Dr. West looked at both men with a loss of words. He shook his head and turned to Dr. Benton noting anther man hovering behind him. "I don't understand. Dr. Carter, it is very advisable that you accept some form of pain medication. I can give you 10 to 15 milligrams of Morphine IM, or maybe 75 to 100 milligrams of Demerol IM. If you don't want to take it orally I can put it in an IV."

Carter closed his eyes as he saw Mark stand next to the gurney beside Dr. West. He wasn't up for a confrontation considering his care. "No. I don't want any pain medication. I'll take some aspirin. Dr. Benton understands, he's my doctor." Carter looked past Mark and at Peter.

Peter had three different people staring at him for answers, each with a different kind of expression. He looked away from all of them for a second and searched his heart. Carter had just called him "his" doctor. He trusted him. Benton returned his gaze to Dr. West.

"Yes, I'm his doctor. If he doesn't want any pain medication then do not give it to him." Peter didn't like what he was saying, but it was what Carter really wanted.

Dr. West indicated for the nurse to take his patient for his head CT. Then he placed his hands on his hips in obvious irritation. It was late at night and he didn't seem to enthused to be playing a role in some power play. He looked over at they guy with glasses who was trying to send lightning bolts with his eyes to the surgeon. The guy with the glasses turned to him.

"I'm Dr. Mark Greene, and Dr. Benton is no longer Dr. Carter's physician. He hasn't been his care giverr in over three months. I have to disagree with Dr. Benton's opinion."

Dr. West clasped his hands together. "I don't know what is going on here, but my patient has a fractured sternum and broken ribs. The man is in pain. Right now he is my patient and he is in my hospital."

"And he also clearly indicated that he doesn't want to be administered morphine," Peter told him forcefully. "He has the right to refuse."

"Peter, you know under the circumstances in which he made that decision. Its in his best interest..."

"Mark, I think we should respect his wishes. Let him take control of some aspect of his life," Peter said wearily.

"Excuse me, sirs. If you are truly being this man's friend then I suggest that you change his mind. He is within his rights, but I don't think it's his best care right now," Dr. West tried to reason.

Peter turned to the both of them. "For once I am being his friend. He has to start fighting his problem. If he wants to do it the hard way, then I'll support him." Peter took a deep breath. "In any way."

Benton turned away to find some place quiet, and away from all the tension.