Chapter Text
Nick’s hair is still damp, the curls pushed back from his forehead in a way that makes him look younger. Denise smooths one of them with her thumb, noticing how warm his skin is under her hand. She keeps her touch light, careful not to disturb anything, and tries to memorise the feel of him like this – the softness of his cheek, the faint dusting of freckles across his nose, the way his lashes rest against his skin.
Kevin sits close on the other side of the bed, leaning forward with his elbows on his knees. Joe stands beside him, quiet, sleeves pulled over his hands. Paul hasn’t moved from the foot of the bed. He’s staring at the monitor, but Denise can tell he isn’t really seeing it. None of them are saying much.
She watches Paul for a moment, the way his shoulders sit too high, the way his jaw keeps tightening. He’s been like this since the woman left them with that folder. He hasn’t said a word about it, but she can feel the tension coming off him in waves. It’s the same tension he carried home from parish meetings, the same tension he tried to hide when he told her the band’s paycheques were behind. He always tries to hide it. He thinks it protects her. It doesn’t.
“You’re quiet,” she says softly.
Paul blinks, as if he’s only just realised she’s speaking to him. “Just thinking.”
She waits, but he doesn’t go on. His eyes drift back to the monitor, unfocused. Denise feels something pinch in her chest – worry, frustration, guilt, all tangled together.
“You’re miles away,” she murmurs.
“I’m right here,” he says, but it sounds automatic.
She looks at him properly then, really looks, and the hurt slips in before she can stop it. “It doesn’t feel like it.”
He exhales through his nose, a tired sound. “Denise, I’m doing my best.”
“I know,” she says, though her voice comes out thinner than she meant. “I just… I need you with me.”
“I am with you.”
“Not right now.”
Kevin shifts in his chair. Joe’s foot starts tapping again. Neither of them looks up, but she knows they’re listening. She hates that. She hates that they’re hearing this, that the strain is spilling out in front of them.
Paul rubs his forehead. “Maybe we should get something to eat. All of us.”
“I’m not hungry.”
“You haven’t eaten since yesterday.”
“I said I’m fine.”
He hesitates. “I can bring something back.”
“I don’t want anything.” It comes out sharper than she intended. She sees the way Paul’s shoulders stiffen, the way Kevin’s gaze drops, the way Joe pulls his sleeves tighter around his hands. She softens her voice. “I just want to stay with him.”
Paul nods slowly. “Okay. We’ll go down for a bit.” He touches her shoulder before stepping away. Kevin and Joe follow him, both glancing back at her before the door closes behind them.
The room settles into a quieter kind of silence. Denise pulls the chair closer and sits beside Nick, resting her hand gently against his hair again. The warmth of him steadies her, even as her heart aches.
“You’re doing so well,” she whispers. “I’m right here.”
She stays like that for a while, letting the rhythm of the ventilator fill the space around her. It’s the only sound in the room, steady and unnatural, but she clings to it anyway.
Sometime later, the door opens softly behind her and she turns, expecting on of the boys. Instead, Doctor Hayes steps inside with a nurse behind him. He gives her a small, warm nod. “Mrs Jonas. Mind if I check on him?”
She shakes her head and moves her chair back a little. “Of course.”
Doctor hayes approaches the bed. “Morning, Nicholas,” he murmurs, adjusting the light above the bed. “Let’s have a look at you.” Denise finds herself smiling softly, comforted by the doctor speaking to her son like he’s a person, not just a chart, even though he can’t respond right now.
The nurse steps to his side, handing him what he needs without being asked. Doctor Hayes checks Nick’s pupils first, leaning in close, his expression focused. He moves the small penlight across each eye, watching carefully.
“Good… that’s good,” he says under his breath.
He checks the dressing at Nick’s temple next, lifting the edge just enough to see the skin beneath. “No new swelling here,” he notes quietly. “Looks clean.”
Denise watches every movement, her hands clasped tightly in her lap. She tries to read his face, but Doctor hayes is careful.
He listens to Nick’s chest, placing the stethoscope gently against his skin. “Breath sounds are clear on the left… right side’s a little quieter, but that’s expected with the position he’s in.” He glances at the ventilator screen. “Settings look good.”
The nurse adjusts one of the IV lines and Doctor Hayes checks the arterial line at Nick’s wrist. He presses lightly against the skin, watching the waveform on the monitor. “Good perfusion here,” he says. “Warm hands. That’s what we want.”
Denise nods, even though he isn’t looking at her.
Then he moves to the foot of the bed, checking Nick’s toes, pressing gently against the pads of them. “Cap refill’s a little slow,” he murmurs. “Not worrying, but something to keep an eye on.” He straightens, glancing at the nurse. “Can you get his latest labs?” She nods and steps toward the end of the bed, flipping open a clipboard.
Doctor Hayes turns toward the catheter bag next, and Denise feels her breath catch before he even says anything. He studies the level for a moment, then crouches slightly to look more closely. His expression doesn’t change much – just a small tightening around his eyes – but it’s enough.
He stands again and reaches for the chart at the end of the bed. He flips to the latest entries, scanning them carefully. Then he goes back a page. And another.
Denise’s heart starts to thud. “Doctor?” she asks quietly.
Doctor Hayes looks up, and his voice is gentle. “His urine output is still lower than we’d like.”
She swallows. “Is that… is that dangerous?”
“It can be,” he says honestly, “but we caught it early. His kidneys are under strain – that’s not unusual in severe DKA, especially after everything he’s been through. We’re adjusting his fluids and monitoring him closely.”
He turns back to the chart, reading the numbers again. “Creatinine’s up a little from this morning. Not a huge jump, but enough that we need to pay attention.”
The nurse brings up the labs on a separate piece of paper. Doctor Hayes steps over, scanning them with a frown that’s more thoughtful than alarmed. “BUN’s climbing too,” he says quietly. “Electrolytes are drifting.” He fiddles with the corner of the page. “Let’s increase his fluids by ten percent and recheck in two hours.”
The nurse nods and makes the adjustment.
Doctor Hayes returns to the bedside, resting a hand lightly on the rail. “He’s stable,” he says, meeting Denise’s eyes. “But his kidneys are working harder than they should be. We’re doing everything we can to support them.”
Denise nods, though her throat feels tight. “Is he… is he in pain?”
“No,” Doctor Hayes says gently. “He’s comfortable. The sedation keeps him settled.”
She nods again, blinking hard.
The door opens behind them, and Paul steps back into the room with Kevin and Joe. They all pause when they see Doctor Hayes at the bedside, the nurse on the other side of the bed, and Denise – pale and tense in her chair.
Doctor Hayes straightens. “Good timing,” he says softly.
Paul steps closer, Kevin and Joe hovering just behind him. Denise feels Paul’s hand settle on her shoulder, but his grip is tense, like he’s bracing himself.
Doctor Hayes keeps his voice low. “So… the good news first. His blood sugar is coming down the way we want it to. We’re keeping it a little higher than normal for now – that helps protect his brain while it’s still swollen – but it’s moving in the right direction.”
Kevin nods, eyes fixed on Nick’s face.
“And the acid in his blood is improving,” Doctor Hayes continues. “That’s one of the big things we watch in DKA. He’s not out of it yet, but he’s heading the right way.”
Joe shifts his weight, sleeves pulled over his hands again.
Doctor Hayes glances at the dressing on Nick’s head. “As for the surgery… he’s stable. The swelling is still there, but that’s expected. Nothing new or worrying from that side of things. Doctor Amir will be in shortly to check him over.”
Denise lets out a breath she didn’t realise she’d been holding. Then Doctor Hayes pauses – just long enough for her stomach to drop.
“There is something we’re keeping a close eye on,” he says gently. “His kidneys are having a harder time than we’d like.”
Paul’s hand tightens of her shoulder and Denise swallows. “What does that mean?”
“It means they’re not making as much urine as they should be,” Doctor Hayes says. “They’re a bit sluggish. When a child comes in as sick as Nick did – very dehydrated, very acidotic – the kidneys can get overwhelmed. And with the surgery and everything else his body’s been through… they’re under strain.”
Joe’s breath catches. Kevin looks at the catheter bag, then quickly looks away.
“Is this… dangerous?” Paul asks, voice low.
“It can be,” Doctor Hayes says honestly, “but we’re watching him very closely. We’ve increased his fluids to give the kidneys more support. Sometimes they just need time and a bit of help to wake back up.”
Denise’s voice is barely there. “Are they… shutting down?”
“No,” Doctor Hayes says immediately. “They’re struggling, but they’re not shutting down. We’re not talking about anything like that right now. We just need to see how he responds over the next few hours.”
Hours, Denise notices. Hours. Not days.
Doctor Hayes softens his tone even further. “This isn’t unusual for a child who came in as sick as Nick did. It doesn’t mean he won’t recover. It just means we need to be careful.”
Kevin steps closer to the bed, brushing his finger against Nick’s arm. Joe presses his knuckles to his mouth, trying to steady himself. Paul’s breathing has gone shallow.
Doctor Hayes closes the chart gently. “I’ll be back soon. And Doctor Amir will be here shortly to talk you through the neurological side of things in more detail.” He gives them a small, reassuring nod before stepping out with the nurse. The door closes softly behind him.
Denise turns back to Nick, her hand finding his hair almost without thinking. His curls have started to dry, falling softly against his forehead, and she smooths them back the way she used to when he was little and feverish. His skin is warm under her fingertips. That’s what she holds onto – the familiar shape of his face, the quiet rise of his chest. She leans in a little closer, as if being near him might steady something inside her, and whispers, barely audible, “I’m right here, sweetheart.”
The door opens again a little while later, and Denise looks up. This time, it’s Doctor Amir. He’s in clean scrubs and a white coat, hair neatly combed back, the faint scent of soap still clinging to him. He looks rested.
“Good morning,” he says softly as he steps inside.
Paul straightens. Kevin and Joe drift closer to the bed, both of them watching the doctor anxiously.
Doctor Amir moves to Nick’s bedside, resting one hand lightly on the rail. He takes a moment to simply look at Nick. His expression softens with quiet concern that feels deeply human. “Alright,” he murmurs gently, “let’s take a look at him.”
He starts with Nick’s pupils, lifting each eyelid with practiced care. The penlight clicks softly as he checks the response. “Good,” he says quietly. “That’s a nice reaction.”
Then he moves to Nick’s arm, lifting it gently by the wrist. He lets it go, watching how it falls back to the bed. “That’s fine,” he says. “His tone is where I’d expect it to be with the sedation.”
He checks the other arm, then the legs, moving slowly, watching the monitor as he does. The heart rate stays steady.
He glances at the ventilator, watching the rhythm. “He’s breathing well with the machine,” he says. “No signs of him fighting it. That’s good.”
He checks the dressing at Nick’s temple next, easing back the edge just enough to see the skin beneath. “No new swelling here,” he says. “That’s what we want.”
He rests two fingers lightly against Nick’s jaw, checking for any twitching or tension. “Nice and relaxed,” he murmurs. Then he steps back, giving the family his full attention.
Paul clears his throat. “How… how is he doing?”
Doctor Amir folds his arms loosely, his posture relaxed but attentive. “The surgery did what it needed to do,” he says. “We were able to relieve the pressure quickly, and that gave his brain the best chance to recover.”
Kevin’s jaw tightens. Joe looks down at the floor.
“But,” Doctor Amir continues gently, “what happened yesterday was very serious. When the pressure rose, his brain was under a lot of strain. Even though the surgery went well, the swelling doesn’t disappear straight away. It takes time.”
Denise’s thumb brushes softly across Nick’s cheek.
“We’re keeping him deeply sedated to protect him,” Doctor Amir says. “If he were awake, even a little, his brain would have to work harder. We don’t want that yet.”
Paul nods slowly. “So… you’re not waking him up today.”
“No,” Doctor Amir says softly. “Not today. Probably not tomorrow either. We’ll take this slowly. When the swelling starts to settle, we’ll lighten the sedation and see how he responds.”
Denise swallows. “And when you do… what will you be looking for?”
“Small things,” Doctor Amir says. “Movement. Reflexes. Eye opening. How he reacts to touch or sound. Every child is different. We won’t know anything until we try.” He hesitates then, and Denise feels her stomach tighten.
“There’s something else I want you to be aware of,” he says. “After an injury like Nick’s, the brain can be… irritable. It’s not uncommon for children to have seizures in the days after herniation.”
Kevin looks up sharply. Joe’s hands disappear deeper into his sleeves.
“Seizures?” Paul repeats.
“Yes,” Doctor Amir says. “They can be small – a twitch in the face, a hand jerking, changes in his breathing pattern. Sometimes the monitors pick it up before we do. He’s on medication to help prevent them, but they can still happen.”
Denise’s voice is barely audible. “Would that mean… more damage?”
“Not necessarily,” Doctor Amir says gently. “It just means his brain is recovering from a very big shock. If he does seize, we’ll treat it quickly. We’re prepared for it.” He gives them a moment to absorb that.
“Right now,” he says, “the most important thing is that he’s stable. His numbers are steady. The surgery site looks good. He’s holding his own.”
Denise nods, though her eyes are burning.
Doctor Amir softens his voice even further. “He’s a strong kid. And he’s young – that’s on his side. Children recover in ways that surprise us.” He rests a hand briefly on the bed rail, his expression warm and sincere. “I’ll be back later. If anything changes, you’ll know immediately.” He gives them a small, reassuring nod before stepping out.