Short of Breath By dee_ayy@yahoo.com, with a big assist from Keryn. Disclaimer: They belong to 1013 Productions and 20th Century Fox (or is that Fox 2000?). I won't say no infringement intended, because we all know that legally it is infringement, and it certainly is intentional. So let's just say no harm intended, no profit made, and hope they leave it at that. Rating: PG-13 for language. MTA rating? Hmmm. We have paramedics and ERs (twice!) and a life-threatening event on a plane, and tests and surgery. . . . It's off the scale and all over the place! The things we do to the poor guy. Archive: This is pure MTA stuff. Who else would want it? But if they do, sure, why not. Feedback: Is encouraged and expected. Tell me I'm a sick puppy. dee_ayy@yahoo.com. I'll pass anything I get on to Keryn. dee_ayy's Thanks: I may have written the story, but it could never have happened without the technical expertise of and thousands of "plot" (such as it is) suggestions from Keryn. Oh, and the subject matter was her idea, too. Maybe she's the sick puppy. She says she doesn't write, but she practically wrote this one, and it was fun putting her ideas and procedures into narrative form. And I may have snuck this one up on you, Vickie, but you still are the slavedriving force that keeps me in front of the computer writing these things. You. I do it all for you. I hope you enjoy it. Summary: No plot, no story, not really. Just pure unadulterated, unabashed, unapologetic, unrelenting medical Mulder torture. Oh, and there's a heavy dose of Scully concern, with a dollop of Skinner concern thrown in for good measure. __________________________________________ Short of Breath (1 of 2) By dee_ayy with Keryn He had only run a little over a mile when Mulder had to stop. He was out of breath, and he had a cramp in his left side. Sure, he was getting over a cold, but this was ridiculous. He leaned over, placing his hands on his knees, and took deep breaths. It hurt. He must have pulled a muscle, dammit. He walked in circles, so as not to cool down too much, and waited for his breath to return. When he felt a little better, he started jogging again, but more slowly. It still hurt. Rather than go forward he turned around and headed toward home. * * * * * "Mulder, what's the matter?" "Huh?" "You're rubbing your shoulder." Mulder looked down at himself and noticed that he had indeed been absentmindedly rubbing his left shoulder. It hurt. "It's nothing, Scully. I think I pulled a muscle while running the other day. Just aches a little." "Is it swollen?" "No, no. It just hurts a little bit." "Did you take anything?" Mulder had to smile. "It's not that bad. Really, it's nothing." "Mulder, you've been rubbing it for half an hour! Where does it hurt?" "Enough, Scully! It's fine. Look!" He moved his shoulder in every direction he could think of to prove his point, and barely flinched. "It's nothing." "Take some aspirin, Mulder. It's an anti-inflammatory." "Yeah, whatever." The pain that had been in his side two days ago seemed to have moved to his shoulder blade. But he wasn't going to tell his partner that. * * * * * Mulder awoke with a start. He was on his sofa, and the television was broadcasting a test pattern instead of the late-night Sonics game he'd been watching. He looked at the clock--3:42am. His heart was pounding in his chest, and he felt like he was hyperventilating a little. He must have had another dream, but oddly enough, he couldn't remember it. That was rare. He got up to get a glass of water but had barely made it to the kitchen when the pain hit him. Before he knew it, he was on all fours on the kitchen floor. The pain was sharp, and stabbing, in his left shoulder radiating down his arm and through his chest. He tried to take a deep breath, and couldn't. He tried again, and it just hurt more. He felt the panic rising in his throat and tried to calm down, but couldn't seem to do that either. He leaned back on his heels, with his hands still on the floor, and waited for it to pass. Two minutes. Three. It didn't pass. He had to do something, or he'd pass out on the floor. He reached for the kitchen counter, and tried to pull himself up to his feet. No go. As soon as he started to get vertical, the pain sent him crashing to the floor again. He only had one option. He crawled. He crawled back into the living room, and sat on the floor, next to the phone. He decided to wait another minute and see if it went away. It didn't. He picked up the phone, and hit the first number on his speed dial. "Hi, you've reached Dana Scully. I can't take your call, but if you'll leave a message . . ." Shit. Where was she? ". . . after the beep, I'll get back to you." "Scully, it's me. Call me. _Please._ It's urgent." He knew the message, and the tone of his voice, would make _her_ panic, too, but he couldn't help it. He didn't want to hide it. Not this time. He was in trouble. Shit. Now he remembered. She was God knows where "antiquing" with her mom. She hadn't left a number, because she didn't know how far out into the Virginia countryside they'd get. Bet she didn't take her cell phone. He dialed the number. It wasn't turned on. Count her out. So you die on the floor, Mulder, or you get someone else to help you. He dialed again. "9-1-1 emergency, operator 802." "Yes. . . . My name is Fox Mulder. . . . I think I need some help." "What is the problem, Mr. Mulder?" "Pain. In my chest." "Are you experiencing difficulty breathing?" "Uhh, yeah. A little." "Okay, Mr. Mulder, are you at 2630 Hegel Place, apartment 42?" "Yes." "Are you alone?" "Yes." "Okay, the EMS has been dispatched already. Stay on the line with me Mr. Mulder, okay?" "Okay." He was gasping from the pain. "Is your door unlocked, Mr. Mulder?" "Ummm, no. It's locked." "Do you think you can get to the door to unlock it for the paramedics?" Mulder measured the distance with his eyes. No way. "Don't . . . think so." "Is there someone with a key who can let them in?" "The super has a key. . . . On the first floor, apartment 10." "Okay, that's great. I'll let them know. Can you describe your symptoms for me?" "Sharp pain. . . . In my chest . . . down my arm. Can't catch my breath." "Are you sitting up or lying down now?" "Sitting." "Are you lightheaded or dizzy, Mr. Mulder?" "No. . . . Not really." "Good, good. The paramedics should be there any second. Can you hear them yet?" Mulder listened. He did hear sirens. They were getting closer. "I think so." "Great. I've told them to get the key from the super. They'll be there in a second. Stay on the line with me until they get there, okay?" "Yeah." "Will the EMS be able to find you, Mr. Mulder? Should I tell them where you are?" "No. . . . I'm . . . on the floor. In the living room. . . . Can't miss me." Mulder heard the EMS operator chuckle. He wasn't trying to be funny. Mulder heard the sound of footsteps in the hallway. "They're coming." "That's good Mr. Mulder. But don't hang up until they're inside, okay? When they get in give the phone to one of the paramedics, okay?" "Okay." The door opened, and Mulder saw several men, backlit by the hallway light, entering his apartment "They're here." "Well, you're in good hands now, Mr. Mulder. Give the phone over, and good luck, okay?" He handed the phone to the first medic to reach him. "It's 9-1-1." "Hi, this is Alexandria EMS. We've got him. Thanks." The paramedic turned off the phone, dropped it on the floor, and turned his attention to his patient. "Mr. Mulder? I understand you are experiencing chest pain?" Mulder nodded. "Where is it located?" Mulder didn't answer. He was busy watching the buzz around him. Someone had turned on the lights. A stretcher was wheeled in. Another paramedic was opening cases and equipment on the ground next to him. Two firemen were standing right inside the door. So was his super. His apartment was suddenly very crowded. "Mr. Mulder? Mr. Mulder? Pay attention here. Where is your pain located?" Mulder turned his attention back to the first medic. His name tag said his name was Karl. "On my left side. In my chest, down my arm. In my back." "Do all of these places hurt, or is it radiating?" "Radiating. Down my arm, to my back." Karl was feeling his pulse. "Can you describe it for me? Would you say it's crushing, or stabbing, or just an ache?" "It's kind of a shooting pain." Karl was taking his blood pressure. "What were you doing when the pain became unbearable?" "I woke up. I went into the kitchen and it just dropped me." "It's onset was sudden?" "Very." "Okay. And how long ago was this?" Mulder looked at the clock. "About half an hour ago." "On a scale of one to ten, ten being the worst, how would you rate this pain?" "Ummm. I don't know. Seven maybe?" "Have you been sick recently? Suffered any injuries?" "I had a bad cold about a week ago. No injuries recently, no." "You look like you're having a little trouble breathing, Mr. Mulder. Are you?" "Umm, yeah. Can't catch my breath. Like I'm hyperventilating a little." "You might be. Do you have a history of heart problems, Mr. Mulder?" Heart problems. Mulder had suspected this; he'd read about what heart attacks felt like, and they felt like this. But he'd dare not say it, not even to himself. Now Karl was saying it for him. "No. None." "We're gonna get you hooked up to a monitor here, and see what's going on, okay? We need to cut your t-shirt off you." "No! Pull it off. Over my head. It's my favorite." "That should be the least of your worries, Mr. Mulder." "You are obviously not a Knicks fan." Karl laughed and pulled the Knicks shirt over Mulder's head. "Well, you still have a sense of humor, Mr. Mulder. That's usually the first thing to go." "Just a defense mechanism. To stave off the panic." Karl smiled at his patient. "No cause to panic, Mr. Mulder. You're doing great." Karl attached the monitor leads to Mulder's chest. It showed a fast, but steady beat, which the paramedic studied for a bit. "Well, Mr. Mulder, so far that looks pretty good. But we're not going to take any chances here. We need get an IV going in case you need some medicine in a hurry, okay? And we're going to hook you up to some oxygen to help your breathing." The other medic--his name was Larry--attached the oxygen mask around Mulder's head. The oxygen helped immediately. Mulder could tell. He didn't look while Karl stuck the IV needle in his right arm. Larry picked up the radio to relay information to the hospital. "How old are you Mr. Mulder?" "37." Mulder listened as Larry talked about him to the hospital. The words meant nothing to him. He knew that by now he should know if 136 over 96 was a good or bad blood pressure. But he didn't. He knew who would, and he wished she was there right now. "Okay, Mr. Mulder, we're going to take you to Alexandria Memorial and get you checked out. We need to get you on the stretcher. Think you can help us out?" "I think so." The pain was a little better, it seemed to Mulder. Probably because he was less anxious now that help was here. The two paramedics moved the stretcher next to Mulder, then firmly supported him by the arms as he lifted himself onto it. In no time he was strapped in, with the still-beeping heart monitor between his feet. "Mr. Mulder, do you have a wallet, some keys you want to bring with you?" "On the table there." Karl went to the table, and saw Mulder's service weapon next to the wallet. "Mr. Mulder, what about this?" He pointed to the gun. "I'm an FBI agent. The small key on the ring is for the bottom desk drawer. Put the it in there and lock it." Karl locked up the weapon, and helped Larry maneuver the stretcher through the door and into the hallway. It looked to Mulder as if all of his neighbors were in the hallway to see what was going on. He closed his eyes so he wouldn't have to look at them looking at him. * * * * * By the time Mulder reached the hospital he was feeling a lot better. As he'd told Karl on the ride, the pain was now about a four. Nevertheless, Mulder became the most popular guy in the room when he was wheeled through the ER doors. Doctors and nurses swarmed the gurney and quickly ushered it into a treatment room. Karl relayed his vital signs and symptoms to the staff, helped them disconnect Mulder from the EMS equipment, then wished the FBI agent luck and was gone. The oxygen mask he had been wearing was replaced with a nasal cannula, making it much easier to speak. "Mr. Mulder, I'm Dr. Smith, and this is Dr. Chamberlain, how are you feeling right now?" Mulder noted that Dr. Chamberlain looked like he was about 16. "A little better." "Better in what way? Less pain?" "Yes. It's not stabbing any more." "Okay, that's good. And the pain started when?" "A little before four." "Okay, about an hour ago. We're going to do an ECG and get a good look at what your heart is doing. But the one the medics did in the field looks pretty good. So you just relax for a minute, okay?" Several more leads were attached to Mulder's chest, and he was hooked up to the much larger machine in the room. A BP cuff was attached to his arm which automatically inflated and took his BP at the touch of a button. A pulse oximeter was clipped onto his index finger. Mulder sat back and watched the machine spit out a long string of paper, which Dr. Chamberlain ripped off after about a minute, studied, and handed to Dr. Smith. "Looks normal to me." Dr. Smith concurred. "Better get a blood gas just to be safe. And a chest x-ray." He turned to Mulder. "Well, your ECG looks normal, and your BP is only a little bit high, Mr. Mulder. Right now I'd venture to say it doesn't look like you are having a heart attack. Your respirations are a little rapid, but that's par for the course when you are wheeled in on a stretcher, isn't it? We're going to do a couple more tests just to totally rule out that your heart is involved, and then we'll work on figuring out what it really is, okay?" Mulder nodded. "I'm going to leave you in Dr. Chamberlain's capable hands, and I'll check back in a bit." It felt like a 50-pound weight that Mulder didn't realize he'd been carrying had been lifted from his shoulders. Okay, so it wasn't a heart attack. And suddenly no one here seemed very concerned. He began to wonder if he should be feeling stupid. Instead he sized up Dr. Chamberlain. He had to be an intern. Dr. Chamberlain caught Mulder's stare. "I'm older than I look. What I need to do now is draw some blood from an artery in your wrist. It's going to be uncomfortable, but it's imperative that you keep your wrist completely still, okay?" "I've had blood drawn before." "Ever had an arterial blood gas drawn?" "I don't know. Doesn't sound familiar." "Well, you'd remember." Dr. Chamberlain asked a nurse to hold Mulder's left wrist down on the gurney, which she did. "I'm really good at this, Mr. Mulder, so it will only take a second. _Don't move_." And he stabbed. As usual, Mulder didn't look, but it felt like he was being stabbed in the wrist. None of the pin prick shit like when they draw blood from your elbow. This was straight in, and excruciating. He clenched his fist so tight his knuckles were white, but he didn't move. And then it was over. "There, not so bad." "Speak for yourself! What is that for?" "Well, arterial blood is blood coming straight from your heart. By examining that blood we can see if your heart is functioning abnormally. If you are having a myocardial infarction--a heart attack--the gas levels in this blood will be all screwed up. We're just doing it to rule out the MI at this point." "In other words, you're torturing me for the fun of it." Chamberlain smiled. "I wouldn't go that far. Can you sit up for me? I want to listen to your chest." Mulder sat up and the young doctor listened to Mulder's lungs. "Have you recently been ill, Mr. Mulder?" "I had a nasty cold a little while ago. Got over it about a week ago." "Was it in your head, or in your chest?" "In my chest." "You had a cough?" "Yeah. Why?" "Well, your left lung sounds a little funny. Probably just some residual congestion from the cold. Are you still feeling short of breath?" "No." "How about injuries. Have you injured yourself recently?" "Ummm, no. Strained a muscle in my side while running this week, but it was only sore for a day or two, and then it went away." "Which side?" "The left." "Tell me if any of this hurts, okay?" Dr. Chamberlain lifted Mulder's left arm up, and prodded the various muscles along his rib cage. Nothing. He moved Mulder's arm, and prodded the muscles on his back. He hit one spot below Mulder's shoulder blade that caused a little twinge, and Mulder just barely flinched, but the young doctor noticed. "That hurt?" "Only a little bit." "Is that where it hurt earlier in the week?" "Yeah, pretty much." "Okay. And what did you eat today?" "Ummm. I don't remember. Not much. Leftover Indian takeout was the last thing I ate." "When was that?" "Ummm, about 10." "Is your stomach upset, are you nauseous at all?" "No." "Have you been?" "No, not at all." "Okay. Well, that does it for now. We're gonna take an x-ray of your chest, and by then the test results should be back." Chamberlain left the room. A second later someone peeked her head in the doorway. "Mr. Mulder?" "Yeah." "Hi. I'm Kelly, the x-ray tech. Let's go take some pictures." She disconnected him from his heart monitor and oxygen, unlocked the wheels of the gurney, and started pushing it down the hall to x-ray. "What's your first name?" "That's okay. Just call me Mulder." "What's the matter, hate your name?" "You could say that." Kelly pushed the stretcher into the x-ray room, and grabbed his left wrist, so as to look at his first name on the hospital bracelet. "Oh, can't say I blame you there. It's unique, anyway." "That's putting it nicely." "I dunno. 'Fox.' I kinda like it." "You can have it then." Kelly laughed. "Okay, what I need you to do now is put your hands on your head, like this." She picked up his hands and placed them on top of his head, with his elbows together in front of his face. Mulder grimaced. "Does that hurt?" "A little. Yeah." "Think you can hold it for a minute?" "Sure." She placed the lead blanket on his lap, and put the x-ray screen perpendicular to his left side. She positioned him in the middle of the screen, sat him up straight, and moved behind her protective screen. "Okay, Mr. Mulder, sit up very straight, take a deep breath, and hold it." Mulder did as was asked. And something happened. The pain went away. Just like that, it ended. It had been dissipating gradually all along, and now it was completely gone. He heard the whir of the machine as it took its picture. "Great. You can breathe and put your hands down now." He did. "Now I need you to turn and face the screen. Hang your legs over the side of the gurney." He did. "And put your arms around the machine, like you are hugging it." Mulder did, Kelly adjusted him slightly to center him, and returned to her protected spot. "Take another deep breath and hold it, Mr. Mulder." He did, and heard the machine take another picture. "I think we've got it, Mr. Mulder. Make yourself comfortable until I develop these to make sure. It will take just a few minutes." She wasn't lying. In about three minutes she was pushing his stretcher back to his treatment room, where she hooked his heart monitor back up, and tried to reapply the nasal cannula oxygen mask. But Mulder stopped her. "You know, this is gonna sound weird, but I feel fine. I don't need that." "Naah, that doesn't sound weird, Mr. Mulder. But if I don't leave you like I found you, I'm in big trouble. So let me hook this back up for you, okay? Can't hurt you. People pay lots of money for shots of this stuff at those 'oxygen bars,' you know." Mulder grinned slightly and let her finish what she was doing. * * * * * Mulder figured he'd been sitting alone in his little cubicle for at least half an hour, with virtually no one paying him any heed, except for the occasional person he didn't recognize popping a head in, glancing at his heart monitor, and leaving. He knew why, he could hear the bustle of activity in the ER. Something big was going on. Car accident or something. Whatever is was, it was a lot more important than his silly complaint. By now he felt ridiculous, because he felt fine. No pains, no shortness of breath, no twinges, no nothing. He didn't know what had happened, but whatever is was, it was over. Yet he sat there, hooked up to all sorts of machines, like someone on death's door. He pulled the oxygen off his face. He contemplated the IV in his arm, and decided that would be last to go. The thought of pulling that needle out of his arm was decidedly distasteful. Instead he started pulling the monitor leads off his chest. When he disconnected the first one, an alarm sounded. Oops. He should have done it earlier. The alarm sent a nurse running in. "What are you doing, Mr. Mulder?" "I want to go. I feel better." "I'm glad you feel better, but you can't go. You were quite sick just a little while ago. We don't know what caused that." "Look. The doctor just as much as said it wasn't anything serious. I feel fine now. You're busy. I can go now." "Mr. Mulder, stay right where you are. Let me go get your doctor. Please?" She took off, and Mulder decided to give her five minutes. * * * * * "So you want to leave, Mr. Mulder?" "Whatever it was, it's gone now. I'm fine." Dr. Chamberlain perused his chart. "Well, your blood gasses were all normal. So it definitely is not your heart. But let me run one more ECG on you, will you?" Mulder nodded and sat back, allowing the young doctor to reattach the disconnected monitor lead, and run one more printed strip of heart activity. "You are in no pain now?" "None whatsoever." "Did they take a chest x-ray?" "Yeah. A while ago." "Well, we haven't had a chance to look at them yet. We have a multiple trauma going on out there." "All the more reason to let me clear out of here." Dr. Chamberlain thought for a minute, and studied Mulder's chart a bit more. "Okay, I'm going to sign you out. I don't know what it was, but it could have been something as innocuous as gas, coupled with your pulled muscle and the effects of your cold, that caused the pain and shortness of breath. It happens." "Gas. Great. Thanks, doc. As if I don't feel stupid enough." "Oh, no, Mr. Mulder. You did the right thing. Don't _ever_ mess around with chest pain. You should follow-up with your own doctor, though, okay?" Mulder nodded his lie. No way Scully was gonna find out about _this_ little incident. "I'll get an attending to sign off on this, and you can go." Dr. Chamberlain left, and the nurse disconnected the paraphernalia from Mulder. She looked around the room in vain. "Where is your shirt?" Mulder smiled. At least he'd had enough sense not to sacrifice his sacred Knicks shirt to this folly. "I didn't have one when they brought me in." "Oh, okay. Hang on a sec." Within a minute she was back with a green scrub top. "This should do well enough until you get home." Mulder put it on and thanked her. * * * * * When he got home, Mulder went into the bathroom and pulled the scrub top off. He needed a shower. He looked in the mirror, and saw the sticky things from the heart monitor stuck all over his chest. He looked at himself reproachfully. Christ, what an idiot he was. What a fool he'd made of himself. At least no one--especially Scully--had been party to this incident. And no one would ever know. He pulled the things off his chest, pulled the bandage off the IV spot, and briefly examined the bruise that was forming. He started the shower as hot as possible, kicked off his shoes and his sweatpants, and climbed in. It was after 10am before he climbed into bed and fell into an exhausted sleep. * * * * * The phone woke him up. He looked at the clock. It said 4:36, but for a second he had no idea if it was a.m. or p.m. The sound of the machine picking up the call in the living room forced him into action. He grabbed the phone. "Yeah?" His voice was heavy with sleep. "Mulder? Are you okay? What's the matter?" "Uhhh, nothing, Scully. I was asleep." Then he remembered. The phone message. Scully. Shit. He was wide awake now. Fuck. "It's late afternoon! Why are you asleep? What happened?" "Nothing Scully. I'm fine." "Mulder! That message! What's going on?" Time to lie. He sighed heavily. "Okay, Scully, I had a nightmare, okay? I was half asleep when I left that message. I barely even _remember_ leaving that message. I don't even know what time it was. But I'm fine now. Okay?" He could hear Scully relax. It was working. "You sure, Mulder?" "Positive, Scully. I'm fine. So, did you find any antiques?" "Oh, as if you care. You want to talk about your dream?" "Do I ever? Nope, forget it, Agent Scully. I already have. But thanks for waking me up. I'm starving. I'll see you tomorrow, bright and early." After she had hung up, Mulder congratulated himself on his quick thinking. Make your neuroses work for you, he always said. * * * * * "I wonder what we did." Mulder was muttering. "What?" "Nothing." "What do you mean, 'what we did'?" Mulder gave his partner a perturbed look--why'd she ask what he said when she'd heard it the first time? "When is the last time Skinner sent us to do backup on a raid? A raid of money launderers at 9 p.m., no less? What did we do to get this shitty assignment?" "Come on, Mulder. Someone had to do it. Might as well be us. Besides, we'll be out of here in fifteen minutes. They're going in." "It's _still_ a shitty assignment. They're _accountants_, Scully. Do they strike you as the type to make a break out the back?" No sooner had he said it when they watched a middle-aged man with a beer gut sneak out the back door and look around furtively. "Guess so, Mulder." Scully was almost laughing. "Fuck." Mulder got out of the car and turned on the headlights, which were pointed at the door. "Sir? Federal Agent. Stay where you are." He flashed his badge over the top of the car toward the suspect. The man stopped dead, stared for a moment at Mulder, and started to run. Scully got out of the car then, and Mulder took off after him, cursing the whole time. About 45 seconds later the chase was over, and Mulder was sitting on the man's back. Scully was right behind him. "Why do they always run, Scully?" She noticed that Mulder seemed to be out of breath, but didn't think much about it. He got off the man, and they hauled him up and brought him around to the front of the building, where the other suspects were being loaded into a van. They added their guy to queue, gave a brief account of what happened to the agent in charge, and were dismissed. * * * * * Mulder pulled up in front of Scully's apartment. "I'll see you tomorrow, Mulder. Good night." "Yeah, 'night Scully." He watched her until she was safely in the building. Now that she was out of the car, he adjusted the radio dial to the all-sports station, sure they'd have a game on. Sure enough, Bullets vs. Hawks. Not the Knicks, but it would do. He put the car into gear, and that's when the first pain shot through his left side. It was just like four nights ago. That gas thing. He steeled himself, put his foot on the gas, and pulled away from the curb. He'd get home, and it would pass, just like last time. By the time he got to the corner, it was excruciating. Instead of taking the left to head home, he turned right, then right again, then again and again. By the time he got around the block and was back in front of Scully's building, he couldn't breathe. He beeped the horn, and hoped it would bring her to the window. It didn't. He couldn't get out of the car. He was paralyzed with pain and fear. He leaned his elbow on the horn, and didn't let up. Then he thought of the phone. * * * * * Scully was drawing a bath when she heard the first beep. She hated it when people did that. So inconsiderate. It started again, and this time didn't stop. It was almost like someone was asleep on the horn--or they were being an asshole. She went into her living room to peek out the window and see what was going on out there. She saw the car. It looked like Mulder's, but she'd watched him drive away not two minutes ago. Her cell phone rang. "Scully." "Scully, outside. Help me." It hardly sounded like him at all. She flew out the door and raced to the car. Scully threw open the door, finding Mulder slumped over the steering wheel. "Oh my God Mulder, what's wrong?" He turned to look at her, fear in his eyes. He was gasping. "Can't breathe. Chest hurts." "Can you move over? Let me in." She helped him slide into the passenger seat, and took his place behind the wheel. She loosened his tie, unbuttoned the top button of his shirt, and felt his neck for the pulse, which was racing. She watched him struggle for breath. "We've got to get you to a hospital." She put the car in gear and pulled away. "What happened, Mulder?" "Don't know. Hit me at the corner. Knew I wouldn't get home, so I came back." She could tell that speaking was an effort, so she decided not to ask any more questions. She just reached over and put her hand on his shoulder. "It'll be all right." * * * * * Scully parked the car in the ambulance bay of Northeast Georgetown Medical Center. "I'm gonna go get help." She raced through the automatic door. "Excuse me! We need some help out here." The person behind the desk looked up. "My partner his having trouble breathing. He says his chest hurts." A woman who had been standing with her back to them turned around. "My name's Carol Hadley. I'm a nurse." She called to two orderlies to bring a stretcher, and Scully led them to Mulder. He was practically curled in the fetal position on the seat. As the orderlies lifted Mulder onto the stretcher the nurse turned to Scully. "How long ago did this start?" "About 10 minutes ago." "Was it sudden?" They were moving now, and the nurse was taking Mulder's pulse as she spoke. Mulder was just gasping for breath. "Very. He dropped me off and was fine when he drove away, and two minutes later he was back in front of my house like this." They pushed through the doors, and the nurse called out "What's open?" Someone answered "Three, or trauma two." "We're taking him to trauma two. Get Bellows, will you?" The nurse turned her attention to Mulder. "Can you describe the sensation for me?" Now Mulder had to speak. "Can't take breath. At all. Just. Gasping." "Are you in pain?" "Stabbing pain. Shoulder." "Have you experienced anything like this before?" "No, he hasn't." Mulder grabbed Scully's arm to quiet her. "Yes. Saturday night. They said it was nothing." "They?" "Alexandria Memorial. It went away. They said it was gas. Or pulled muscle." Scully's jaw was on the floor. "Was it exactly the same as this?" "No. More pain last time. But easier to breathe." The nurse took a stethoscope and placed it on the left side of Mulder's chest. "Take as deep a breath as you can for me." He did, and the expression on her face changed. "Have you been in an accident recently? Received a blow to the ribs or chest?" "No." The nurse poked her head out the door of the room. "Can I get some help in here? And where's Doctor Bellows? Tell him we have a possible pneumothorax in trauma two, will you?" Mulder looked at his partner. "What's?" "It's a collapsed lung, Mulder. She thinks you have a collapsed lung." He didn't seem to care for more of an explanation than that. He was just intent on getting a breath. It took the ER staff about 30 seconds to strip Mulder to the waist, settle him onto the gurney, and hook him up the heart monitor. Scully never left his side. By then the doctor had arrived. "What have we got?" Nurse Hadley reported her findings. "Mr. Mulder presented at the ER about 5 minutes ago complaining of severe shortness of breath and pain in the left chest. Pulse is strong but rapid, BP within normal. But respirations are rapid and shallow, and I picked up virtually no breath sounds on the left side." "Let's get an IV going, get a blood gas, and start him on 3 liters O-2, shall we?" Everything was a well-choreographed flurry of activity from then on. Mulder's right arm was hooked to the IV. The other was stabbed at the wrist for the blood gas, causing Mulder to moan loudly as a nasal cannula was put into his nostrils. The doctor watched the oximeter give it's reading, and whistled under his breath. "Switch that to full mask, 10 liters, will you? And can we get a portable chest in here, stat!" "What?" Scully definitely sounded alarmed. The doctor noticed her for the first time. "Who are you? " "He's an FBI agent. I'm his partner. I'm also a doctor." "Well, the oxygen level in your partner's blood is quite low right now." He turned to the nurse. "You call the pneumothorax?" "Umm, I did." "Good call." He turned to Mulder while reading the information on his chart. "Mr. Mulder, we need an x-ray to confirm, but I'm pretty sure you've got a collapsed lung. It says here you had an episode like this a few days ago?" Mulder nodded. "Did they take a chest x-ray?" Mulder nodded again. "And no one mentioned the word 'pneumothorax'?" Mulder shook his head, and then pushed the oxygen mask aside so he could speak. "Don't think. Anyone looked at them. Busy. Pain stopped. So I left." Short, clipped sentence fragments were all he could manage between breaths. "They let you leave?" "Didn't like it. But yeah." "Well, it is likely that the collapse wasn't very big then. They are easy for the inexperienced to miss if they involve less than 30% of the lung." Mulder sort of sighed. "Doctor was Doogie Howser." Dr. Bellows chuckled. "Well, there you go. This time I promise you it will show up. It's bad enough to effect the oxygenation of your blood, and we can't hear your left lung working at all right now. The collapse has obviously worsened considerably in these last few days." "Sounds bad." "Well, it's not good, Mr. Mulder, but we'll take care of it." The X-ray machine had arrived, and Scully and the doctor left the room for the minute it took to take the picture. * * * * * It only took a minute for the x-ray to be developed, and the room remained abuzz with activity. Mulder was placed slightly on his right side, and the left side of his chest was draped. A tray of equipment was set up next to him. Everyone in the room put on gowns and masks and gloves. Mulder was alarmed. The x-ray was delivered to the room, and placed on the view screen, where Bellows inspected it for about 5 seconds. "Well, sure enough, you have a collapsed lung, Mr. Mulder. We need to get a chest tube in you _right_now_." Mulder looked at his partner, and saw her flinch. He questioned her with his eyes, and she nodded. Anyone who paid attention could see that Mulder's heart rate was skyrocketing. Dr. Bellows noticed. "No need to be anxious, Mr. Mulder. But let's help you relax a little. Have you ever had Valium?" Scully decided to take this one. "He's allergic to Ativan, and doesn't react well to morphine. Valium is okay. Can I stay?" "Put on a gown and a mask, and stay by your partner's head, and I don't see why not. Might help him to have a friendly face around, you know?" Scully nodded, and went to gown up. The doctor ordered the drug, and it was inserted into Mulder's IV. Scully sat on a stool right in front of Mulder's face. All he could see was her eyes. The rest was covered with the mask. He flinched when he felt a cold liquid being swathed on his side. Scully touched his face to get his attention, and took both his hands in her own. "That's Betadine, Mulder, an antiseptic. Next they are going give you a shot in your side. That's Lidocaine, a local anesthetic. Listen to me, Mulder. This is going to hurt. I won't lie to you. I want you to hold my hands, and look straight into my eyes, okay? We'll do this together." Without any warning, the doctor began. "Scalpel." Mulder felt the pressure of the scalpel on his skin, which then gave way to the cut, but he felt no pain. He closed his eyes. "Hemostat." Scully broke her gaze from Mulder, and watched the surgeon take the long curved instrument and insert it into the incision. Mulder's scream of agony and his vice-like grip on her hands immediately brought her back to his face. "Okay, Mulder, it's okay. Look at me. Focus on me. I'm here." His eyes had been clenched shut tightly, but he opened them, and found his partner's clear blue eyes locking with his again. Her look was almost fierce, as if she was trying to give him strength. He loosened his grip on her hands. And though his jaw was still clenched with pain, the word he was hissing was very audible, even through the oxygen mask: "FuckFuckFuckFuckFuck." Her eyes softened. "I know it hurts. It's almost over." Dr. Bellows removed the hemostat and replaced it with his fingers. He stuck them in the hole and poked around, to be sure he was in the right place. Mulder screamed again, and Scully had to pin his left arm down to keep it from flailing wildly. She found that tears of empathy were forming in her own eyes. So much for being strong. She blinked them away. "Almost done, Mulder. Almost done." The doctor removed his fingers and inserted the tube. Once it was in place he called for a suture, and actually stitched it in place in his chest. A bandage covered with petroleum jelly was placed around the tube to create an air-tight seal, and the tube was attached to a Pleurivac water suction device. Mulder was returned to lying on his back. The whole thing had only taken a couple of minutes. "There you go, Mr. Mulder. Quick and easy. We'll take another x-ray to make sure it is in the right place, and get you settled in a room. I'll make sure you get something for the pain, and you should be much more comfortable in just a little while." He turned to someone in the room. "Get the portable in here, will you? I think Mr. Mulder has had enough moving around for the time being. Let's cut him a break." Scully wiped her partner's brow. He was still breathing with some difficulty, but it was better. His face, however, was etched with pain. "How are you doing?" He didn't open his eyes, and his voice was barely a whisper. Scully had to lean in close just to hear him. "Just let me die before you let them do _that_ again, Scully." "I know, Mulder, I know." "No, you don't." "But it's over now. It's all over." The x-ray technologist had arrived with the portable machine, and Scully was asked to leave the room. "Take it easy, Mulder. I'll be right back." He didn't respond in any way. * * * * * Dr. Bellows was at the nurse's station, writing on Mulder's chart, when Scully approached. "Dr. Bellows, how is he?" The doctor looked up. "It's a fairly complete pneumothorax, which is pretty rare for a first one. Are you sure he's never suffered from one before?" "I'm positive. He's had his share of injuries, but never a collapsed lung. I'm fairly knowledgeable of his medical history. Except for last Saturday night. He'd failed to mention that to me." "We've put a call in to Alexandria Memorial for those records. I'm betting we'll see a small pneumothorax on the x-rays. Like I said, they're easy to miss. Especially if his symptoms dissipated completely. Looks like it just got worse in the days between now and then. Did you notice anything?" "Well, now that you mention it, he did complain of a sore shoulder last week. And he seemed to lack energy today." "Classic symptoms. But really you'd never suspect a lung until it's collapsed so much you think you're dying." Bellows smiled kindly at her. "How long will he be in here?" "Impossible to say. We'll x-ray his chest daily to chart his progress. It could be a couple of days, it could be longer. If the lung doesn't adequately reinflate within a week, though, then we need to consider the possibility that the leak isn't healing, and go in and do something about it. But that's not something to think about now. This is most likely just a freak, one-time thing that will heal itself. Let's hope so, anyway. We'll run a few tests to rule out the remote possibility that this is secondary to some other condition." "Like what?" "Ohh, TB, emphysema, asthma, a tumor." The doctor saw Scully blanch. "I don't expect to find anything. These just happen sometimes. Especially to tall lanky males under 40. But still, best to be sure. We'll start with some blood work and take it from there." Bellows looked up and saw the x-ray machine being wheeled out of Mulder's room. "Let's go see how he's doing." Mulder was lying, with his head slightly elevated, on the gurney. Someone had finished undressing him, and he was in a hospital gown. He looked pale, and completely drained. But he managed to open his eyes when Scully and Bellows entered. "Let me formally introduce myself, Mr. Mulder. I'm Doctor Hank Bellows. I'm a cardiothoracic surgeon here, specializing in pulmonary problems--the lungs. Nurse Hadley did you a big favor calling me right away like she did, if I do say so myself." "How'd this happen?" Mulder had been trying to remember an injury, and he couldn't think of a thing. "Sometimes collapsed lungs happen spontaneously, Mr. Mulder--especially to men with your build, for some reason. Sometimes there's no explanation at all. We'll do some tests to see if there is an underlying reason, but I doubt we'll find one. What happened is that air seeped outside the confines of your lung, and filled a portion of your chest cavity that is usually reserved for your expanded lung. The more air there is in the chest cavity, the less space there is for your lung to expand, hence the shortness of breath and the low oxygen levels in your blood. Your left lung was only working at about 30%. 70% of the space was filled with air, and we had to start getting that out immediately, or the pressure could have kept building and affected your heart." "What did you do to me?" "We put in a chest tube, Mr. Mulder. We put a tube into the chest cavity, into the air pocket, to let the air seep out. This machine here, called a Pleurivac, will help that. It will make sure the air comes out without any more going in. As the air comes out, your lung will reinflate, provided the cause of the air leak, usually a sort of air-filled blister on the surface of your lung--called a bleb--that ruptures, has healed." "If it hasn't?" "Let's not worry about that now, Mr. Mulder. We'll cross that bridge if we come to it." "How long?" "How long does it take to drain?" "Yeah." "That depends on whether or not the lung is still leaking air. Usually it takes a few days." "DAYS?" This news roused Mulder quite a bit. "Indeed, Mr. Mulder. We suction it out quickly and we can do permanent damage to your lung. It is best to just let these things take care of themselves, more or less." The look of resignation on Mulder's face was apparent. Plus the Demerol was kicking in, and he was finding it increasingly difficult to keep his eyes open. "You get some sleep, Mr. Mulder. I can answer any more questions you have in the morning." * * * * * Scully entered Mulder's room, after giving the nurses a few moments to get him settled. "Is he asleep?" She was speaking quietly. The nurse adjusting Mulder's IV looked up. "I think so." Mulder stirred and forced his eyes open. "Not yet." Scully smiled and approached her partner. "And _why_ not?" "Waiting for you." "Well, I'm here. Feeling any better?" "No." "Well, then, go to sleep. I promise you'll feel better in the morning." "'K. Thanks Scully. Don't be here when I wake up." Scully chuckled, but didn't bother replying. Mulder had drifted off. She settled herself into the uncomfortable chair in the room for another all-night vigil. The nurse studied her for a minute. "You're not leaving?" "I don't leave him." Scully's tone was matter-of-fact. The nurse sized her up for a minute, and then left. A moment later an orderly came in, pushing a reclining chair. "Thought you might be more comfortable in this." Scully thanked the man, climbed in, and kicked out the footrest. In no time she was asleep, too. * * * * * A shaft of sunlight hitting her eyes woke Scully up. She looked at her watch; it was just after six. She looked over at her partner, who was still asleep. His breathing, despite the nasal cannula still delivering oxygen to his lungs, still sounded funny, she thought. But the sound of the Pleurivac machine practically drowned out every other noise. She grabbed her purse and headed to the cafeteria for a much-needed cup of coffee. * * * * * Scully had stayed away for over an hour. She'd had some breakfast, freshened up in the ladies' room, and gone outside for a bit of fresh air. When she returned she hoped he would be awake, and she wasn't disappointed. She peeked her head in the door. "Hey." "Hey. You didn't change your clothes, Agent Scully." "Forget about it, Mulder. How're you feeling?" "Better, I guess. This," he motioned to the chest tube, "hurts like hell, Scully." "I know, Mulder. But if not for that you'd be dead right now, so don't complain too much." "Seriously?" "Sure. It's possible. If the air in your chest kept increasing it could have stopped your heart." "Geezus." "Exactly. Mulder, why didn't you tell me about Saturday? Is _that_ what that phone message had been about?" Mulder looked away from her. "Yeah. I forgot you were away when I called. I swear, Scully, I thought I was having a heart attack. But then it went away, just like that, and they told me it was gas. Christ, that was embarrassing, you know? I didn't want to tell you." "Did you think I'd laugh at you? ME?" She went to the side of his bed and touched his arm. "Mulder, please, don't do that again. If you'd told me maybe I could have gotten the records. Maybe we could have avoided getting to this point." "What point is that, Scully? What point are we at? What's going on?" He knew he was changing the subject. That was his intention. But he did want to know. "We wait, Mulder. We wait for the chest tube to do it's job, and for your lung to reexpand. Could be a couple of days, could be longer. There's no way to know right now." "But how did this happen? Why?" "I don't know, Mulder. I really don't. Guess you're just lucky." She smiled and took his hand for a second. "You want me to bring you anything?" * * * * * One day passed. Two. Three. Mulder felt better each day, but each day he was told "Not yet." His lung was reexpanding, but slowly. The doctors did not feel comfortable letting him go home yet. By the fourth day he was climbing the walls. He had just called for the nurse for the third time in an hour, so that was who he was expecting when the door opened. But it was his boss instead. Mulder instantly sat up straighter in bed. "Sir. What are you doing here?" "I stopped in to visit a friend whose wife just had a baby, so I thought I'd see how you are doing." "I'm fine, sir. Really." Skinner had walked around the bed and was sizing up the Pleurivac suction machine. "'Fine' people don't have contraptions like that hooked to them, Agent Mulder." Mulder tried to smile. "True. But it's getting better, every day. I should be out of here in a day or two, I think." It wasn't really a lie. More like wishful thinking. "Good to hear, Agent. I hope you'll be able to return to work shortly after?" "Sure. I think so. I'll be good as new, they tell me." Fact was, the subject of his line of work hadn't come up yet. A nurse entered. "You called?" Her tone was annoyed. Mulder couldn't remember why he'd called. "Umm, never mind. I'm fine." "Glad to hear it. Do us a favor, Mr. Mulder? Try not to call because you're bored any more? Next time you ring, at least make up a reason, okay?" Her smile was frosty as she left. Skinner was amused. "Bored, Agent Mulder?" "Totally. I feel basically fine, as long as I don't move around too much. But I'm trapped here because of that." He motioned toward the Pleurivac. "And do you have _any_ idea what is on television during the day in the middle of the week?" The AD laughed. "I do. I remember. Why haven't you gotten your laptop in here and caught up on some paperwork or something?" "I'd rather watch The Price Is Right, sir." He smiled at his superior. "But seriously. I don't know. Haven't really felt up to it until now, I guess. But when you get back to the office could you ask Scully to bring some stuff when she comes by after work?" "Be glad to, agent." Skinner looked at his watch. "Well, I'd better get back to it. Glad to see you looking well. Take care of yourself." "Thanks sir. Thanks for dropping by." Skinner pulled open the door and found himself face to face with Dr. Bellows. The two men nodded to each other as one left and the other entered. The doctor gave his patient a "who's that?" look. "My boss. Guess he wanted to make sure I wasn't faking it or something. The magic water machine over here seemed to convince him, though." Dr. Bellows smiled, pulled up a chair, and sat down. "So, let's talk about what's going on." "That sounds ominous." "Oh, no, not at all. This morning's x-ray is better than yesterday's. You're making steady progress. Maybe a little slower than some, but steady. We have every reason to believe the 'leak' is healing itself, if it hasn't already. Keep it up and I'd say you should be out of here by Wednesday. Right under the one-week deadline I impose on my pneumo patients." "Deadline?" "If you're not off the Pleurivac in a week, it's time to talk surgery to repair the damage to the lung, because it's obviously not healing itself." "But I don't need that?" "Nope, don't think you will. Keep your fingers crossed, Mulder, that you keep going in the right direction." "And what about when I get out of here? What then?" "Well, your lung won't be back to 100% when you go. You'll still be dealing with maybe a 20% collapse. These are almost always asymptomatic, and your body can resolve them itself. But you'll have to take it easy for a couple of weeks. Give your body time to do its job. We're talking nothing strenuous at all, nothing that will stress your lungs at all. No high altitudes, no strenuous exercise. You'll actually have a doctor's permission to take the elevator instead of the stairs, and to drive absolutely everywhere you go. Stuff like that." "And what about work?" "A week or so at home, then you can go back to the office, But I won't clear you for the field until I am certain the collapse is 100% resolved. As I told you yesterday, we found absolutely no underlying cause for this. But idiopathic spontaneous pneumothoraces are not uncommon. For many people it's a one-time deal, which never happens again. Hopefully you will fall in that category." "What if I don't?" "You'll know if you don't Mulder. It will collapse again. And I think by now you have a very good handle on what the symptoms of that are." "How can I prevent it?" "You can't. You just can't. Just live your life. If it's gonna happen again, it's gonna happen again. There's nothing you can do about it." "Great." "I know, not very encouraging. But they usually recur in younger people--teens, people in their early 20s. At least you don't have that strike against you!" "Never thought I'd be glad to be getting 'up there.'" "Age has its advantages, Mulder. Do you have any more questions?" "No. Maybe Scully will, though. I'll send her after you if she does." Dr. Bellows smiled. In the last four days he had fielded plenty of questions from the petite federal agent who looked over her partner with a ferociousness usually reserved for a spouse. "I'll look forward to it. Just a little while more on the wet-vac there, and we'll get you out of here." * * * * * Scully had taken the morning off so she could be with Mulder when he found out if, in fact, he was going to be released. She couldn't help but be nervous, afraid that the latest x-ray would show that his progress had stopped, and they would have to start talking surgery. But she didn't want to convey that concern to her partner. "Honestly, Mulder, how can you be watching 'Price is Right?'" "Hey, don't knock it, Scully. I'm great at pricing the cars. But the kitchen appliances? Forget it! Do _you_ know how much a side-by-side fridge costs?" "Does it have an ice maker?" Mulder just mock-glared at her. Their banter was interrupted by the door. It was Dr. Bellows. Mulder turned off the TV. "So, Agent Mulder. Want to go home?" Mulder grinned, and Scully almost laughed. "Absolutely. Yank this thing, will you?" "Not so fast. The x-ray looked great. The pneumothorax barely shows up at all now. I think we'll definitely get you home today. But before we pull the tube, We need to make sure you're still not leaking air in there." "How do you do that?" The doctor had moved next to the Pleurivac, and was watching the water intently. "Cough for me." Mulder coughed, and winced. "Again." Mulder did. "That was the first test. If you still had a pleural air leak, coughing would have caused the water to bubble. But it didn't. That's good. Next we clamp the tube--leave it in, but stop the suction. Wait a few hours, take another x-ray, and hope the pneumothorax hasn't grown." Ever the realist, Scully had to ask. "If it has?" "Trouble. Means that the chest tube has been draining air faster than the lung was leaking it, but that the leak is still there. And if it hasn't healed itself in a week, chances are it won't. My deadline, remember?" He directed that last question to Mulder, who nodded. "But let's be optimistic here. No reason whatsoever not to be. Let's get on with it." The doctor pulled a clamp from his pocket, and attached it to the tube leading from Mulder's chest to the machine on the floor. Once clamped, he turned the machine off, creating an unnatural quiet in the room. "Ahhh, silence is golden, huh?" "I don't know, doc, I'd gotten used to it. Do they make tapes of that noise? I may not be able to sleep without it." "Funny, Mulder. We'll take you down for another x-ray in about 4 hours--at around 2 or 3. And take it from there. I'll see you later." With that the doctor left. Scully pulled out her cell phone. "Who are you calling?" "Skinner. I want to tell him I won't be in at all today." "You can go, Scully. Honestly, I'm just going to sit here for four hours, twiddling my thumbs, as usual. No use in both of us doing it." "Nope, I'm sticking around. I'll go get us something decent for lunch, maybe. Any requests?" * * * * * It was 5pm. The tube had been clamped for 6 1/2 hours. The x-ray had been taken two hours ago, and still they hadn't heard anything. Both Mulder and Scully were getting anxious. "I'm going to go and find out what's taking so long, Mulder." "No, don't, Scully. If it's bad news I don't want you to go looking for it." "Do you feel like you're getting short of breath?" "Nope. I feel absolutely fine. Perfect. Good as new. Except for the garden hose in my side." "I'm sure Dr. Bellows just got held up." * * * * * At 7:30pm Dr. Bellows finally entered Mulder's room. Scully was pissed, but she purposefully kept her tone of voice measured. "You know, it would have been nice if someone had told us if you were going to be this late." "You didn't get the message?" "What message?" "Sorry, folks. I was in surgery. An emergency. Everyone on my afternoon schedule was supposed to have been notified." Mulder had had enough with the apologies. "SO?" "So, let's pull that tube. The morning and afternoon x-rays are absolutely identical. We'll get you home by bedtime. How's that?" "Great. Pull it." "I'll be right back." Bellows returned with a nurse, who was carrying a tray of supplies. They were both in gowns, with masks on. The nurse laid Mulder's bed flat, and raised it up as high as it would go. Dr. Bellows then lowered the bed rail on Mulder's left side, and placed a pad under his side. "Okay Mulder, I'm going to cut the stitches. You shouldn't feel that at all. When I tell you to, I want you to take a deep breath, and then try to blow it out your mouth while keeping your windpipe closed. I want you to fill your lungs and build the pressure in there by trying to blow it out. Do you know what I mean?" "Yeah, I got it." "When you're doing that I'll be pulling the tube. It might hurt, but it will be nothing compared to when we put it in, okay?" "Yeah, okay." The doctor put on gloves, and took the scissors the nurse held out. Two snips, and the stitches were out. He handed back the scissors, and took a gauze bandage covered in goop. Mulder felt the cold of the jelly against his side. "It's just petroleum jelly, Mulder. We've got to make sure there's an air tight seal while it heals. Would hate to be letting air in there from the outside after all this work, huh?" Mulder nodded. "Okay, ready whenever you are. Take in as big a breath as you can, and blow it out without blowing it out." Mulder did. He felt the doctor press firmly into side, and felt the tube as it slid by the surface of his skin. He didn't look. Instead he watched Scully's face, as she watched the procedure. She had a faint look of disgust on her face. It only took a few seconds, and he felt the tube come free of his body. What hurt was the doctor pressing the bandage over the hole. He let the breath out. "Owww! Watch that!" "Sorry about that. Like I said, got to get the dressing on there firmly, or we defeat the whole purpose." The doctor placed what looked like a _very_ large Band-Aid over the spot. "One more x-ray, and you're out of here." "Another one? I'm gonna start glowing or something." "I know. But sometimes removing a chest tube can cause a pneumo, believe it or not." "I can breathe fine. Honest." "Just precautionary. I'll go down and wait for it to be developed so you can get out of here immediately, okay?" "Yeah, whatever." Mulder made quite a deal of the fact that he could get into the wheelchair without all sorts of accompanying machinery. "I'll be right back, Scully." "I'll pack up your stuff, Mulder." She followed him out into the hall, and approached the doctor once Mulder was in the elevator. "Dr. Bellows?" "Why did I know you'd have questions?" He smiled at the agent. "Should he. . . can he be left alone? Should I take him home with me?" "He might be a little tired for a few days--he probably will be. I've already told him to take it easy, and frankly, he won't _want_ to be running any marathons. But as far as day-to-day living? He's perfectly capable of taking care of himself. He doesn't need any special home care beyond the care of the wound, which we'll tell him about as soon as he gets back from x-ray, and which he can do himself." "What if it collapses again?" "I'll give you the same advice I gave him. Don't live your life waiting for it to happen again. It might, it might not. There is nothing you can do to prevent it from happening, so why worry about it?" "What if it collapses when he's alone?" "It has, Agent Scully. Twice. And both times he got himself some help. He'll be fine. Don't baby him." Chastised, Scully blushed slightly. "Thanks, Doctor Bellows." "No problem. None at all." * * * * * "Are you sure you don't want to spend a few days at my place, Mulder?" "_No_, Scully. I want to be HOME. Home, get it?" He rapped his knuckles on his own front door for emphasis. "I'll be fine." He unlocked the door, and sighed audibly after he passed through the threshold. "God, it's good to take a deep breath again." "You want me to stay with you tonight?" "And sleep where? On the sofa? Please. I don't need any help. You heard them at the hospital. Take it easy, change the dressing. See Doctor Bellows next week. I've got it covered. It's late. Go home." "Let's get you settled." "I _am_ settled, Scully. All I need to do is brush my teeth and hit the sack. Or do you want to tuck me in?" he smiled at her mischievously. "Really, though, Scully, thanks for everything. But I'm fine. I'll talk to you tomorrow. Go." She didn't want to, but she left. * * * * * Mulder had just gotten out of the shower when the phone rang. "Yeah?" "It's me. I'm coming with you today." He knew it. "No, Scully, I'm _fine_! I don't need you coming with me!" "Hey, I've been through this whole thing so far. Why not stick with you through your first follow-up visit?" "Maybe because you have work to do? Or is it that you don't trust me?" "Very perceptive, Agent Mulder. Appointment's at 10, right?" "Yeah." "I'll pick you up at 9:15." "Yes mom." * * * * * More x-rays. At least this time he could stand. Turn this way, that way, deep breath and hold it. Mulder was sure that by the time he was through this ordeal, he'd be qualified to run an x-ray machine. * * * * * "So, Mulder, looking good." Dr. Bellows breezed into his office, and smiled upon seeing Scully sitting in the room with his patient. "Ahh, Frick and Frack. Shoulda known!" Mulder gave his partner an annoyed glance. The doctor put Mulder's x-ray up on the view screen, and pointed to an imperceptible shadow in one corner of the left side of his chest. "That's all that's left, right there. Almost nothing. Maybe 8-10%" "I don't see it." Mulder looked to Scully, who shrugged. She didn't see it either. "Good! You shouldn't! It's that little area right there. Doesn't matter. It's there, trust me. But not for long, I dare say. How have you been feeling?" "Good. I was a little tired the first couple of days, but now I feel good as new." "Well, that's to be expected. But even though you feel good as new, I still want you to take it real easy for another week or so. Give that lung plenty of time to heal up for good, understand?" "What about work? Can I go to work?" "Can you stay behind your desk?" Scully smiled. "I can _make_ him stay behind his desk." She looked at her partner. "Knew there was a reason for me to come." Bellows smiled. "Okay, then, how about this. It's Thursday. Stay home and relax through the weekend. Monday you can go back to work. But I haven't cleared you for the field, and I won't until I see you again in another week. You can slowly start increasing your activities. Just don't be foolish. You run, right?" "Yeah." "Well, don't. Not until I see you again." "Aye aye." * * * * * Mulder breezed into their office with a big grin on his face. "What are you so happy about?" "This, Scully." Mulder was brandishing a piece of paper. "It's my 'note from the doctor.' We are back in business!" "Let me see that." She snatched the paper from his hand and studied it. "Don't believe me? Dr. Bellows missed you, you know." She glanced up at him with that annoyed, pursed-lips-look of hers that Mulder found alternately endearing, and annoying. Today it was endearing. "Gimme that. I have to go deliver it." * * * * * Assistant Director Walter Skinner looked up at Mulder entered. "What is it, Agent Mulder?" "Here, sir. It's my release for field duty, effective immediately." Skinner took the paper. Mulder thought he saw a fleeting grin cross the AD's face, but maybe not. He studied the paper. "This is good news, agent. Very good." "Thanks, sir. Do you have anything for us?" "Not at the moment. I'll let you know, though." * * * * * The commuter flight was packed, and Mulder was crammed into a middle seat midway back in the coach cabin, with his boss next to him. Scully was in the middle seat a few rows back. Mulder had expected Scully to sit next to him, and had fully intended to appeal to her shorter legs to get the aisle seat for himself, but when he saw Skinner storing his gear in the overhead compartment above him, he knew he'd miscalculated. They were returning from a conference at the New York office. It continued tomorrow, but Mulder and Scully had managed to convince their superior that a day spent studying the uses of computer-aided design devices to reconstruct bombed structures was not something they would have much need for on the X-Files. He'd given them the go-ahead to go home the same day they'd arrived, and at the last minute had decided to join them. Mulder pulled his pair of walkman earphones out of his pocket and put them on. They weren't connected to anything--the cord just ended in his pocket. He just did this when he feared he was sitting next to a "talker." The guy in the window seat definitely looked like a talker. And then there was Skinner. Mulder definitely was not in the mood to make small talk with him. He closed his eyes, pretending to doze, and awaited takeoff. As the plane ascended Mulder felt an odd tightness in his chest, but thought nothing of it. Probably just some residual effect of the damn chest tube. It had only been a little over two weeks, after all. Fifteen minutes into the 40-minute flight, he started to worry. Something wasn't right. He was getting short of breath again. But there was no pain. Maybe it was just his imagination. Twenty minutes into the flight the pain started. And he started to panic. He wasn't sure exactly where Scully was; he didn't want to alarm his boss. He was starting to sweat. He didn't know what to do. "Agent Mulder, are you all right?" Guess Skinner noticed. "Sir, can you get Scully for me?" "Is there anything I can do?" "No. Just get her. NOW." Skinner headed to the back of the plane. Mulder's neighbors were suddenly aware that they were potentially in the middle of an unfolding drama. Mulder had been right--the window-seat guy was a talker. "Hey, buddy, you all right? You look kinda sick. Bad flyer, are you? I used to get all worked up about flying myself. You know what you need to do? Get yourself three or four cocktails before you get on board. Don't buy them on board, of course, that's a rip-off. Nope, just a couple of Scotch and sodas in the lounge, and you don't care if you have an hour of turbulence!" Mulder just closed his eyes, ignored him, and concentrated on his breathing. "Mulder, what's wrong?" Mulder opened his eyes. Scully had taken Skinner's seat, and the AD was looming large in the tiny aisle. "I dunno, Scully, I think it might be collapsing again. I'm getting short of breath. My arm hurts." Scully called a flight attendant, whose nametag read "Amy," over. "Is there somewhere we can take him? He's ill. He has a collapsing lung. We're gonna need some oxygen, too." "The flight is completely booked, I'm sorry. There isn't a single empty seat on the plane." Scully looked around the plane. "Then can we rearrange people so we're together in the bulkhead? We're going to need to get him off this plane the second it lands." "We can do that, I'm sure." She looked at Mulder, who was a ghostly shade of white by now. "Do you want me to request an emergency landing? I'm not sure where we are, but we may be able to get down in a few minutes, in Wilmington or Philadelphia." By now the entire coach section knew something was going on. People were standing and craning over their seats to see. "How long until we land?" Amy looked at her watch. "About 23 minutes if we're on schedule, which we should be." Scully looked at her partner "How are you doing, partner? You want off this bird, or can you make it home?" "Let's get home." "Okay." She turned back to the flight attendant. "He should be all right. But we need to have an ambulance waiting on the runway, okay? And we REALLY need oxygen." The flight attendant went to her coworkers. One went up to the cockpit to relay the crisis to the pilots. Another set about moving people in the seats closest the door. Skinner helped Scully walk Mulder to his new seat, while Amy took to the microphone. "Ladies and gentleman, we have a slight medical emergency on board. One of our passengers is in need of oxygen. In order to get this to him, we are going to release the oxygen masks from above you. PLEASE disregard them. There is nothing wrong with the cabin pressure." With that admonition she pushed a button, and everyone's masks fell down, just like in the film they showed at the beginning of each flight. Scully fitted the mask over Mulder's face. She watched him for a minute. "That better?" He nodded. "I bet it was the change in pressure, Mulder, in the plane. Maybe from taking two flights in one day." He nodded again. He didn't care what caused it. He just wanted to breathe again. "Take it easy, Mulder. We'll be home soon." Scully looked up and noticed Skinner was still looming overhead, looking concerned. "Sir, Can you get my purse? I left it under the seat in front of me. I was in seat 24b. And there should be a small black nylon bag in the overhead." Skinner left, thankful to have a task. He delivered the two bags to his agent. "What else can I do?" Scully looked around. "Nothing, sir. There's nothing to do until we land." She pulled out a credit card from her wallet, and swiped it through the reader atop the phone in front of her. She picked up the phone and started to dial. "Hello, this is Special Agent Dana Scully of the FBI. It is imperative that I speak to Dr. Bellows. Is he in? . . . He isn't? Where is he, do you know? . . . He is? Great. I need you to get a message to him IMMEDIATELY. I am calling you from a USAIR shuttle flight from New York to DC. One of Dr. Bellows' patients, Fox Mulder, is with me, and he has suffered a collapsed lung on board. As soon as we land we're going to Northeast Georgetown Medical Center. He needs to meet us in the ER, okay? We're going to land in about 15 minutes." She hung up. Mulder watched her, surprisingly calmly, considering what was happening. Scully smiled wanly, and squeezed his hand for support. Mulder continued to watch her silently for a moment, then dared to shift his gaze to his boss, who was now occupying the aisle seat of their row. Skinner could not hide the concern--even fear--in his eyes. "Hang in there." He didn't know what else to say. * * * * * Amy came back on the loudspeaker. "Ladies and gentlemen, we are about to start our descent into Dulles Airport. When we land, however, we must let our ailing passenger off the plane first. So we ask your patience, and let the emergency personnel on board to take care of him and take him off before everyone else disembarks. Thank you for your understanding." Next thing you know she was standing by Scully. "The pilot got us pushed to the front of the queue for landing. We've got first clearance and should be down soon. How is he?" "He's okay. Thanks." But when the plane began it's descent, about nine minutes before actually landing, all hell broke loose for Mulder. The pain in his chest became crushing, and he doubled over in pain. "Mulder! Mulder, what is it? Sir, help me sit him back!" Skinner pushed the younger man back in his seat. "What is it?" "Hurts." It was all he could say, and the one word started him coughing. He hadn't coughed before, Scully knew. She took his pulse, and it was racing so fast she couldn't count it. She fished in the black bag and came up with a stethoscope. She held it to his left lung. "Mulder, try to take a breath for me." Though conscious, Mulder didn't respond at all. Scully moved the stethoscope to his heart. But she had to move it again to find the beat. She pulled the instrument from her ears. "Sir, we have to get him on the floor. NOW." "What is it?" "The pressure. It's building in his chest too fast, and pushing on his heart. If we don't relieve it immediately it will stop." "We're _landing_, agent." "I know sir. But we can't wait another second!" Skinner released his seat belt, and Mulder's, and lowered the agent to the floor. He was lying with his head in the aisle, and was virtually unconscious now, but his eyes were fluttering open. He was breathing so rapidly and shallowly that it hardly looked like he was breathing at all. He was turning blue. "What should I do?" Scully had lowered herself to the floor as well. She was crammed onto the floor between the seats and the wall, actually straddling Mulder at the waist, facing his chest. She was again fishing in her bag. "Open his shirt, sir. I need access to his chest." Skinner pulled Mulder's tie off over his head, and unbuttoned his shirt all the way down to his belt. But the younger agent was wearing a t-shirt. He looked up at Scully, who handed him a pair of scissors. Skinner cut the shirt up the middle. Amy finally noticed what was happening, and rushed over. "What are you doing? We can't land the plane with you on the floor!" "You have to. You have to land IMMEDIATELY, do you hear me?" Scully's voice conveyed control, but was tinged with panic. "We'll be all right. How long until we actually touch down?" Amy looked at her watch. "Five minutes?" Scully had pulled a packet from her bag. She was reading the instructions as she pulled it open. Skinner didn't like the looks of that. "Do you know what you are doing, Agent Scully?" "Yes, sir. But it's been a while. I need to relieve the pressure. Do me a favor, sir. I think he's out, but in case he's not, hold him down. Hold his arms. I don't have any anesthetic." Skinner put his large hands on Mulder's upper arms, and watched Scully as she put on a pair of surgical gloves. She measured a spot on Mulder's chest by counting his ribs, and swathed a spot with a Betadine pad. Then she took what looked to Skinner like the biggest needle he had ever seen, found the spot she had identified on her partner's chest, and thrust it straight in. Mulder wasn't unconscious. Skinner had his arms pinned, and Scully was on his waist, but still he arched his back in protest. But he did not scream. When he had started to move Scully had let go of the needle, and after he settled she continued to insert it. When she stopped she gently pressed on his chest, listening for a sound coming from the needle. When she heard it, she pulled the needle out, leaving a catheter coming out of Mulder's chest. She attached a compressed syringe to the end of the cath, and drew air out of Mulder's chest. She detached the syringe, recompressed it, reattached it, and drew more air out. She was doing this for the third time when the plane actually touched down. The impact sent her left cheek into the carpeted wall of the bulkhead, and Skinner had to hold on tight to the seat next to him, but they made it down safely. Skinner noticed that Mulder was breathing much easier. He seemed to be coming around. But still, Scully was drawing air out of his chest. They were both startled by the captain's voice on the intercom. "Ladies and Gentleman, we are going to stop the plane here on the taxiway and bring up a stairway so our sick passenger can be taken off immediately. It is quite urgent that he get medical attention, and this is the fastest, most efficient method. Paramedics will be boarding the plane and once he is removed, we will proceed to our gate. When we do, we ask that all passengers whose final destination is Washington remain seated until those rushed to make connecting flights have disembarked. Again, thank you for your patience and for flying US Airways." Mulder was stirring. He opened his eyes. "Huh?" "It's all right, Mulder. You're going to be all right." Scully listened as the stairs were attached to the door, and it was thrown open. Two paramedics came aboard with the small seated stretcher they used for maneuvering patients in confined areas. Everyone in the coach section had stood up, and was trying their best to see the action on the floor at the front of the compartment. "What have we got?" One of the paramedics was talking to Scully. "He has a left lung collapse, probably caused by the change in air pressure from the flight. He just recovered from one a couple of weeks ago." The medic spied the catheter. "Who did the needle decompression?" "I did. He became tachycardic and aphasic, then lost consciousness briefly and became cyanotic. I'm a medical doctor. I'm also his partner in the FBI. I started carrying a kit when he suffered the first pneumothorax. Look, that's enough talk. We need to get him to the hospital now." Skinner stood, and helped Scully remove herself from over Mulder's body. He practically lifted the petite woman over the man on the floor, and deposited her in the aisle. The paramedics detached the airplane oxygen mask and attached their own. They lifted Mulder onto the chair, and strapped him in, careful not to disturb the catheter in his chest. Mulder was still somewhat disoriented. He didn't seem aware of what was going on. When the medics started lowering Mulder down the steps to the tarmac, with Scully and Skinner following, the rest of the passengers started to applaud. For the life of her, Scully couldn't figure out why people did stuff like that. * * * * * "Well, Doctor Scully, I dare say you saved your partner's life today." Dr. Bellows had joined Scully and Skinner in the waiting room. Scully had opted to stay with her boss this time. Mulder had been so out of it she doubted he would miss her, and Skinner, despite his best efforts, had seemed upset. "I don't know about that." "Don't be modest. What on earth prompted you to start carrying a needle decompression kit?" "Overcautiousness? I don't know. I just figured it couldn't hurt. And that with Mulder's luck, it might come in handy." She smiled wearily. "Well, it certainly did." "How is he?" "He's out of immediate danger. We've got another chest tube in him." Scully blanched. "Don't worry, this one went in much easier than the last. Mulder barely flinched. Of course, he was barely conscious." Bellows smiled at his own joke. He was the only one. "Anyway, This blowout was huge. SPTs that form tension pneumothoraces are virtually unheard of. I've scheduled him for a CT scan first thing in the morning. I want a good look at that lung. But I suspect that surgery is the only way to get this under control. Two complete collapses within a couple of weeks spells trouble." Skinner had no idea what the doctor was saying. "Excuse me, SPT?" Scully blushed slightly. "Oh, I'm sorry, sir. This is Dr. Bellows, Mulder's doctor. Doctor, this is Assistant Director Walter Skinner." "I know who he is, Agent Scully. But will someone please explain to me what is going on?" This was a man who did not like it when he was not in charge of a situation. "Your agent suffered a spontaneous pneumothorax--or SPT--on the flight this evening. His lung collapsed. Normally with these a finite amount of air is released into the chest cavity, preventing the lung from expanding fully, causing a partially collapsed lung. But in Mulder's case, for some reason the air kept leaking into the chest cavity, creating more and more pressure until it started affecting his heart. That's when Agent Scully here stepped in and saved his life." "Is it still leaking?" "We don't know for sure. Right now his blood oxygen levels are good, his blood gasses are improving. He's resting comfortably. These are good signs. We'll look at the lung tomorrow, and take it from there." "Can we see him?" "Come on." * * * * * Scully led the way into the ER trauma room. The gurgling water sound of the Pleurivac machine made her sigh with a certain level of resignation. Skinner stayed back as the young woman approached her partner. "Mulder?" He opened his eyes, and tried to smile. "You stabbed me." Scully smiled. "It was for your own good." Skinner took this opportunity to step forward. "Your doctor seems to think Agent Scully saved your life." Mulder switched his tired gaze to his boss. "Oh, well, she does that all the time." Skinner allowed himself to grin. "How are you feeling, agent?" "Like a plane landed on my chest. Tired." "Well then, you should rest. You gave us quite a scare." "You and me both." Mulder felt Scully's hand on his. He flipped his over so he could grip hers, and turned to look at her again. "Thanks." Scully smiled. "You go to sleep. I'll be up to see you when you're settled in a room." * * * * * "Hey Mulder. How are you feeling this morning?" Unlike the last time, Mulder was hooked to a heart monitor, and a pulse oximiter was clipped to his finger. They weren't taking any chances. But at least they'd switched from a full mask to a nasal cannula for oxygen during the night, so he could speak easily. "I'm okay, Scully. Everything aches, though." "Well, your tissues went without much oxygen for a bit yesterday. You need time to recover. It'll improve." "So what's next?" "Have you seen Dr. Bellows?" "Not yet." "Did he mention a CT scan?" "Yeah, last night. What's that for?" "He's concerned, Mulder. He wants to find out why you've had two pneumos in a few weeks, and why this one was so bad. The CT scan will give him pictures of your lung, so he can see it better than on an x-ray." "What's he looking for, Scully?" "I don't know, really, Mulder. Probably just blebs. Those air blisters on the surface of the lung." "And?" "I don't know, Mulder. Just wait and we'll ask him. Your CT scan is scheduled for 10. He'll probably be in to see you before then." Scully did not want to be the person to mention the word "surgery" to Mulder again. She'd let the doctor do that. And now was his chance. Dr. Bellows walked in as if called. "Good morning, Mulder. How goes it?" "I ache." "No surprise there. But your numbers are good. You're doing okay." "Just 'okay?'" "Well, yeah. Something's up. You really blew a gasket on that plane. We need to find out what's going on with that lung." "The cat scan?" "Exactly. It will give me a clearer picture of the lung, and what's going on there. We can see the whole thing, get a good look at the surface. I think we'll find either one enormous bleb, or several smaller ones situated very close together, so that if they all burst together, the effect is that same as if it was a biggie." "And these bleb things just _happen_?" "Yup. You may have had them all your life, and some anatomic change recently just started them bursting. Or they may have recently formed. There's no way to know, really." "So what do we do about them?" In anticipation of the doctor's answer, Scully moved protectively closer to her partner. "Well, I want to see the scan first, but right now my inclination is to go in and surgically repair the lung so this doesn't happen again." "Oh, no. No way. No surgery. The other one got better, why won't this one? I'll just stay off planes for a while." "Mulder, it _didn't_ get better. If it had, this wouldn't have happened. And when I sent you home after the last time, it was with the belief that even if it happened again, it wouldn't kill you. But this one almost did. If what happened on that plane happens again, and you are alone, it will kill you. If your partner hadn't been there yesterday, you wouldn't be here today. Am I making myself clear?" Mulder looked at Scully, who nodded her head. "Mulder, he's right. Besides, how can you do your job without getting on planes? You log more frequent flier miles than most pilots." Mulder closed his eyes and rubbed his temples. "You said you wanted to look at this scan first. Just do that, and then we'll talk." * * * * * "We need to disconnect all this stuff so you can go down for your CT scan, Mr. Mulder." The nurse was disconnecting the heart monitor leads from his chest. Then she clamped the chest tube, and disconnected it from the suction. The nurse and an orderly then helped Mulder transfer himself to a gurney, and they started to go. The nurse looked at Scully. "He should be back in about 40 minutes." "Actually, I was planning on going with him." The nurse looked startled. "Oh. Well, that's not normal procedure. I don't know that you can." Mulder looked at the nurse. "If she wants to come, she's coming." The nurse decided to let it go. It wasn't her problem, after all, and the orderly pushed the gurney to the elevator, with Scully alongside. Once inside, Scully noticed Mulder shifting uncomfortably. "You okay?" "I guess so. Damn thing hurts like hell." "Haven't they given you anything?" "Probably. I don't know. It still hurts, though." "When we get back I'll check and see what they have you on. There's no reason for you to be in pain." When they arrived in radiology Scully's presence was met with surprise. The radiologist looked at her skeptically. "Are you family?" Scully looked at Mulder, who was in the other room with the machine, then back at the doctor. "For your purposes, yes. I'm his partner, his next of kin, and a doctor. I want to watch." "Well, you can't be in the room with the patient, but I suppose you can stay in the control room." "That's fine. Can I go in with him to get him settled? I won't stay in there." "No, stay here with me. We'll get him settled." They both turned their attention toward the window into the scan room. The intercom was on, so they could hear what was happening in there, as well as watch. Mulder was moved onto the flat hard surface of the CT scan table. He was still sitting up, and a technologist was speaking to him. "Mr. Mulder, we need you to lie flat, with your arms up under your head, and stay _completely_ still. The test will take about 20 minutes, and we'll start as soon as your doctor gets here. Are you claustrophobic?" Scully saw Mulder shake his head "no," and turned to the radiologist. "Bellows is going to be present for the procedure?" The radiologist looked annoyed. "Yes, he requested to be. It's not uncommon." Mulder put his legs up on the table, and laid down. Thirty seconds after he was laying flat, however, he started to panic, and tried to sit up. "I can't. I can't lay down. I can't breathe." The tech pushed him down again, but the agent kept trying to fight him. The tech looked through the glass at the doctor in the control room, who got on the intercom, and spoke to his patient. "Laying flat increases the feelings of shortness of breath, Mr. Mulder, but I assure you, we wouldn't be doing this if you were in danger. Just concentrate on relaxing, and you'll be fine." Scully pushed the intercom button again. "Mulder, he's right. It'll be okay. Just concentrate on each breath. You'll be fine." Upon hearing her voice, Mulder did as he was asked. It took another moment for Mulder to quell the rising panic, but he settled. The doctor turned his attention to his equipment and then left, but Scully continued to watch and listen to the techs in the other room. "Okay, that's good, Mr. Mulder. Now we need you to put your arms up, and put your hands under your head. This might be uncomfortable around your chest tube, but we really need you in this position." The tech lifted Mulder's right arm and positioned it. Then he moved the left arm up. The very motion of putting the arm over Mulder's head made him cry out in pain. The technologist stopped, and waited a second. When it looked like the pain had passed, he continued to move the arm up and put Mulder's hand under his head. Mulder cried out again, but didn't fight. Scully could see the pain etched all over her partner's face. The tech checked Mulder's position, and seemed satisfied. "I know that's uncomfortable, Mr. Mulder, but it should ease with time. But if it gets unbearable, just shout. If you have any problems just shout. We can hear you. We'll be right in the other room with your lady friend." Mulder nodded. While Scully was watching the men torture her partner, Dr. Bellows had entered the control room. He smiled upon seeing Scully. "I should have guessed." Scully smiled back. "Hey, he keeps asking _me_ all sorts of questions. I want the answers. He's really uncomfortable in there." Bellows grinned sympathetically. "I can imagine. These things are never fun for people with unresolved pneumos. Can't breathe, positioning hurts like hell, right?" Scully nodded. "He'll be all right, I think. The pain should ease, and he'll get used to the shortness of breath. It won't take long. I don't want him off the suction very long anyway." The radiologist came in. "Oh, good, you're here. Let's get started." He flipped on the intercom to speak to Mulder. "Your doctor is here, Mr. Mulder, so we're going to get started. Stay completely still, okay?" "Okay." The radiologist flipped a switch, and the table began to slide inside the hole in the machine. Once Mulder's head was past the middle, the doctor flipped another switch, and images began to appear on the screens in front of them. They were cross-sections of Mulder's lungs. Dr. Bellows studied the various pictures. He requested printouts of several of them. At one point he called Scully over. "Here, look at this. See this?" He pointed to what looked to her like a slight protrusion on the surface of Mulder's lung. "And this?" Another. "And this?" Yet another. Scully nodded. "So far I count six blebs. That's crazy. The good news is that the right lung looks clean. Oftentimes if one lung is compromised, so is the other." The pictures continued. Dr. Bellows continued to print several, and save them to a disk. After about 25 minutes, they were done. When Mulder was removed from the machine, Scully was the first person in the room. "You can take your arms down now, Mulder. Do it slowly, so it doesn't hurt so much. You okay?" Mulder was definitely out of breath. He carefully returned his arms to his side. "My arms are asleep." "I bet." "How'd it go?" "I don't know about these things, Mulder. They found those bleb things. I don't know what it means, though. You'll have to talk to Bellows. He said he'd be up to talk to you in your room in a little while." Orderlies transferred Mulder back to a gurney, and took him back up to his room. * * * * * Scully returned to Mulder's room after a quick trip to the ladies' room. She found a nurse injecting something into Mulder's IV. He was once again hooked up to all his paraphernalia. "Demerol, Scully, the breakfast of champions." "It's almost lunchtime, Mulder." "Picky, picky." "I saw Dr. Bellows out in the hall. He should be in here soon." She sat down in the chair next to his bed. The door opened, but it was Skinner. "Good morning, Agent Mulder. I came by to see how you're doing." "Well, sir, have a seat. We're about to find out." "Excuse me?" Scully shot an annoyed look at her partner. "He just had his CT scan, sir. The doctor is on his way in here with the results. That's what he means." "I see. I'll wait outside, then." "No, that's all right, sir. You can stay. It will just save Scully the trouble of relaying everything to you over the phone." "Are you sure, Agent Mulder?" "Sure. You were in on this episode from the beginning. No secrets here." "Okay, then." Skinner didn't sit. Instead he went to the far corner of the room, and pretended to look out the window while he waited. Dr. Bellows entered and surveyed the room. "A crowd, huh? Are we all staying for this?" He addressed the question to Mulder. "Well, _I'd_ prefer not to. But I don't have much choice. As for the other two, they're staying." Scully had moved her chair closer to Mulder, and discreetly took his right hand in her left. Skinner stayed in the far corner, but turned his attention away from the window and toward the three people across the room. Bellows sat on the edge of Mulder's bed, by his feet. "Okay, here it is. You need surgery." Scully squeezed Mulder's hand. Skinner stood up straighter. Mulder closed his eyes. "Here's why. The CT scan showed at least six blebs clustered close together on the upper lobe of your lung. They must have all blown together on the plane, causing a massive leak into the pleura. You've been on the chest tube for 18 hours, and your x-ray shows no improvement, meaning one or more of them is still leaking. Who knows if it will stop. Even if it does, the likelihood that this will happen again is high. If it happens to the extent that it did on the plane, like I told you earlier, it could kill you." "But it might heal itself?" "There's a remote chance. But I'd say no, Mulder. I don't foresee that happening. This is too severe." Scully squeezed his hand again, and spoke for the first time. "What do you do?" "Well, it's a fairly noninvasive procedure these days. The surgery is called a pleurodesis. The goal is to remove the blebs, and close up the lung. We resect them, or cut them out, and staple the lung where they were. Then we literally rough up the surface of your lung, so it forms scar tissue and 'sticks' the surface of your lung to the inside of your chest wall. There's two ways to do this, either mechanically, by literally roughing it up with something abrasive, or chemically, by introducing a chemical that will cause the surface to scar. I prefer the mechanical. Anyway, we do this so that if more blebs should form, they would not be able to burst, because there would be no room there for the air to escape out of your lung. Once upon a time we'd have to do a thoracotomy, or cut you open from here to here." He demonstrated by drawing a line from the middle of the front of his chest around to the same point on his back. "We broke ribs and everything. It was ugly. But now we have what is called VATS, or video-assisted thoracoscopic surgery. We make three or four small incisions about a half-inch long, and use a camera to see what we are doing inside." "Like a laparotomy?" Scully was trying to find a term Mulder would understand. "Similar, yes. Just in the chest cavity instead of the abdomen." Skinner had moved closer to the bed without anyone noticing. "And the results of this procedure would be?" Mulder was kind of surprised that his boss would speak. "Hopefully 100% recovery. No reason to expect any less." "What about complications?" Leave it to Scully. Mulder was somewhat bewildered, so he let his colleagues ask the questions he was incapable of thinking of at the moment. "Very few. There may be loss of sensation near the incisions, caused by cutting nerves, but that usually returns with time, or the patient adjusts and no longer even notices. It is done under general anesthesia, so there are the inherent risks involved with that. There's still a remote chance of breaking a rib in there, but that heals. And it's never happened to me, if I do say so myself." Finally Mulder spoke. "What if I refuse? What if I want to wait and see?" Bellows looked surprised. "Well, Mulder, I'd consider this to be pretty urgent. But I can't force you into anything. If you want to wait, we wait. But what are you waiting _for_?" "To see if it resolves itself." "It won't, Mulder. And even if it does, it will only be a matter of time before it happens again. That I can promise you." Skinner spoke up now. "And in all good conscience, Agent Mulder, I don't see how I could allow you in the field under those circumstances. Sounds to me like you'd be a ticking time bomb, ready to go off at any moment." "That is a perfect analogy, Mulder. Your boss is right. You'd be like a bomb ready to blow." Mulder sighed as heavily as his collapsed lung would allow, and looked pointedly at his boss. "Letting you stay was a _big_ mistake." He turned his attention back to the doctor. "All right." "So you want to do it?" "You've convinced me. I don't think I have much choice, do I?" "I don't think you do. You're doing the right thing. You don't want to live with the fear, wondering if every twinge is another collapse. I've got everything set up for first thing tomorrow." "Pretty confident, weren't you?" "No, Mulder. Just positive that this is the right course of action, and that you'd see it that way, too." "So tell me again what you're going to do." * * * * * Scully pushed the elevator button, and waited for a second before deciding to take the stairs. She had overslept, and was late. She hoped she hadn't missed him. She ran up the stairs and burst through the door onto Mulder's floor. There he was, on a gurney, waiting for the elevator. It arrived, the doors opened, and the orderly started to push Mulder inside. "Hey! Wait a minute!" The orderly stopped, startled, and Scully ran up to the gurney. Mulder was very drowsy, but he saw her, and smiled a drunken smile. "Hey, Scully." "Didn't want you to go without wishing you luck." "Thanks." "I'll be here when you wake up." Mulder smiled again. "I know." * * * * * Scully was lead into the recovery room. Dr. Bellows said that it had gone perfectly, and she wanted to take her usual place. She'd never let him wake up alone in a recovery room if she could help it. She wasn't going to start now. Mulder was still asleep. He was breathing on his own, but he still had the intubation tube down his throat. She also noted that they had put in an arterial line in his right wrist. That was good. They wouldn't have to hurt him any more to take blood for the arterial blood gas tests they were doing daily. She turned to the nurse who had brought her in. "Why is he still intubated?" "It's just a precaution. In case something goes wrong in these first few hours, we won't have to intubate again. As soon as he's awake and progressing, we'll take it out." "He's going to fight it." "Lots of people do. Don't worry, we can handle it." The nurse smiled kindly, and left Scully alone with her sleeping partner. * * * * * Scully sat quietly, her elbow resting on the bed, her chin in her hand. She knew that with the tube down his throat Mulder wouldn't be able to make a sound, so if she wanted to know the minute he started to wake, she couldn't take her eyes off him. She'd been watching his face intently for almost an hour when his eyelids started to flutter, ever so slightly. She knew what would come next, so she stood and leaned her face close to his ear. With the first gagging cough that indicated he was fighting the tube, she placed her hand on his forehead and spoke directly into his ear. "Mulder, relax. You're okay. There's a tube in your throat to help you breathe. Don't fight it, Mulder, just relax." Mulder heard her voice. He knew what she was saying, but he couldn't help himself. He felt the gag reflex building in him, and all he could do was cough, over and over, making a bizarre hollow sound. But it didn't do any good, the foreign object remained in place. He reached up with his hands toward his throat. Anything to get it out. Scully grabbed his hands and held them at his sides. "Stop, Mulder, it's all right. Stop, please. Relax." Scully was getting concerned. The coughing couldn't be good for him, and it had to hurt. God, he hurt. Each cough sent pain coursing through his chest. But he couldn't seem to stop. Even with Scully begging him to. He opened his eyes. Maybe if he looked at her, she'd understand that he wasn't doing this because he wanted to. Scully watched as Mulder opened his eyes, and sought hers. She saw the pain and the fear in them immediately. She understood and smiled sympathetically at him. "Hey. It's okay. Just relax. It'll stop. Just relax." She ran her fingers through his hair. He liked it when she did that. It always made him feel better. Safe. He took a breath, and for the first time realized that although there was a tube down his throat, he was breathing on his own. That knowledge allowed him to settle a bit. The coughing stopped. For a moment. "Hey, we're awake?" The recovery room nurse had approached, but neither agent had noticed. She checked his various monitors, and that the tube was still firmly in place. "I'll call his doctor." Oh, he didn't want to do it, but he couldn't help it. He started to cough again. The pain brought tears to his eyes. He couldn't help that, either. He reached for his throat again, but Scully stopped him. Scully watched him helplessly. She turned to the nurse, and spoke loudly, and firmly. "He's awake. Can't we remove the tube now?" The nurse approached, so as not to disturb the other patients in the room, something Scully hadn't considered with her little outburst. "Not yet. Dr. Bellows ordered a chest x-ray as soon as he woke. He doesn't want to extubate until he sees the film and gets another blood gas reading. There's a tech on the way up to take the picture." Scully turned back to Mulder. "Listen, Mulder, just a little while longer. They'll take it out soon, I promise. Just breathe, Mulder, breathe. Breathe. Breathe." It started to work. He was concentrating on her voice, breathing in rhythm with her repetition of the word. The gagging stopped. "Breathe. Breathe. Breathe." She kept it up. Anything to stop the horrible sound of that coughing. * * * * * "Hey, I know you! How's it going, _Fox_?" Scully sized up the petite x-ray tech who had approached the bed. "Oh, I see. Tube got your tongue, huh? Sorry about that. Don't say a word." She turned to Scully. "Hi. I'm Kelly. I x-rayed Mr. Mulder over at Alexandria Memorial a few weeks ago. I moonlight there on weekends. And I never forget a patient. Especially not one named 'Fox.'" She winked at the man in the bed. Recognition was dawning in his eyes. "Okay, look. You're going to hate this Mr. Mulder. I need you to sit up to take the x-ray. But the sooner we get this over with, I bet the sooner you get that tube out, okay?" Mulder nodded slightly. Kelly moved the x-ray machine into position. "Okay, up." Scully and Kelly sat Mulder up. He was still very drowsy, and wasn't much help. He started to slump immediately. "I'll help him, Kelly." "You're not pregnant or anything, are you?" "Not a chance." She helped Mulder stay up while Kelly took the x-ray. Then the two women gently laid Mulder back on the bed. And he started to cough again. "Come on, Mulder you can do this. Breathe. Just relax and breathe." As a precaution Scully had leaned across his body, and was holding both his hands by is side. "I'll get this back up here as fast as possible. You take care, _Fox_." Kelly took her x-ray and left. The movement must have done something. Mulder was gagging. He couldn't stop. God, how he tried to relax and breathe, like Scully wanted him to, but it wouldn't work. His body had other ideas. Without being really aware of what he was doing, he tried to thrash out of Scully's grip. His heart monitor started beeping wildly. She held him tighter, and the tone in her voice was stern. "Mulder, stop! Calm down. If you can't calm down they'll have to sedate you. You don't want that, do you?" Scully felt another set of hands around Mulder's left wrist. She looked away from Mulder's face, and saw the nurse attaching a restraint to Mulder's wrist. She came around the bed and did the same to his right wrist. "I'm going to get him a sedative." The nurse left. Mulder pulled at the restraints, but only half-heartedly. He was exhausted, but he couldn't stop gagging. But more than anything he wanted to be able to tell Scully that he wasn't doing this on purpose. Freed from holding him down, Scully moved closer to his head, and again tried the mantra that had worked before. Very quietly and very soothingly, she whispered in his ear, while she petted the top of his head. "Breathe. Breathe. Breathe. Breathe." He listened. He didn't pay attention to anything else. Not the pain, not the feeling of the tube, not the incredible need to gag. Just her voice. And it worked. When the nurse returned with the sedative, she found Mulder quieter. His heart rate had settled. Rather than the constant cough, there was only the occasional gag-like hack. She decided to forego the shot for a minute, and see what happened. Scully never took her eyes from Mulder, and she never broke from their mantra, but the corner of her eye registered the nurse's presence. She stole a glance at her, and shook her head "no." She didn't know how long this was going to work, but as long as it did, she was willing to sit there. She just kept it up. "Breathe. Breathe. Breathe." * * * * * "What's going on?" Dr. Bellows had arrived in the recovery room and spied his patient with his partner whispering in his ear. He directed his question to the nurse. "She's talking him out of fighting the tube. I've never seen anything like it." "How long?" "About 10 minutes now. As long as she keeps whispering he's okay." "So you haven't had to sedate him? "Nope. Put the restraints on, though. But I've got the shot ready to go." She held it up as proof. Bellows smiled, and approached the bed. "Dr. Scully, you can stop that. We're going to pull the tube out now." Scully looked up and blew a strand of hair off her face. "Oh, thank God. I don't know how long I could have kept this up." Bellows sized up Mulder. "Well, by the looks of it, I think you lulled your partner to sleep!" Scully looked. He was asleep. Unbelievable. "Well, you know him. Do we let him sleep, or do we wake him to pull the tube." "Oh, wake him. Definitely. I don't want him waking up on his own and being surprised again." "Okay then let's do it." Bellows called the nurse over, and took Scully's place on Mulder's right, near his head. The nurse approached with a drape, which she placed on Mulder's chest. She disconnected the humidified oxygen that had been hooked to the intubation tube, and turned it off. Bellows used the knuckle of his right index finger, and firmly rubbed it in Mulder's shoulder, just under his shoulder blade. He spoke loudly. "Mulder? Mulder wake up. Open your eyes for me." Mulder's eyes flew open, and the first thing he did was gag on the tube. He'd forgotten about it. "Mulder, we're going to remove the tube from your throat. But we can't do it if you're gagging on it, okay? So just take a second and relax. Just relax." Mulder tried. He felt Scully's hand on his leg--she was now at the foot of his bed. He sought her with his eyes, and found her. She smiled. He relaxed. Bellows was snapping on gloves. "Okay Mulder, what I need you to do is take a deep breath, as deep as you possibly can, and then blow it out as _hard_ as you can. Even when it hurts, and it will, breathe in as _deep_ as you can. Can you do that for me?" Mulder nodded. "Okay, whenever you are ready." Mulder felt Scully's grip tighten on his leg. He started to breathe in deeply. The pain was incredible. He shook his head slightly, and stopped. Bellows understood, and didn't do anything. "Try again, Mulder." Mulder looked at the doctor and blinked once, slowly, in an attempt to tell him he was ready to try again. He breathed in as hard as he could, past the worst of the pain, and then blew out. The nurse had a hand on Mulder's forehead, holding his head down to the bed, and as soon as he started to exhale, Dr. Bellows pulled, hard and fast. Just like that the tube was out and laying on the drape on his chest. Mulder was coughing a hideous, choking cough. The nurse released his head, which Mulder turned to the side, and she put an emesis bowl in front of his mouth. The doctor kept a hand on Mulder's shoulder, waiting for the coughing to pass. He watched the readings on the monitor go slightly haywire, but only with a mild interest. The nurse remained prepared in case the patient vomited. Scully wanted to go to him, to help him more, but she couldn't. She was forced to spectate from the end of the bed. After a couple of horrible minutes, the coughing subsided, and Mulder collapsed, spent, back onto the bed. "Ohhh, brother." Mulder's voice was hoarse from the trauma of the tube and disuse. Dr. Bellows grinned, and patted the younger man on the shoulder. "Don't talk, Mulder. Give your vocal chords a chance to recover. You did just fine. Just fine." The nurse attached an oxygen mask to Mulder's face, and removed the tube. She left and returned with a syringe, which she injected into his IV. Dr. Bellows turned to Scully. "He'll sleep now." * * * * * Skinner and Scully aimlessly filled the space in Mulder's hospital room. He'd been returned from the recovery room about an hour earlier. The day had long since ended, and Skinner, who had come to the hospital after working hours, stared out the window into the darkness. He turned to Scully. "So the doctor was optimistic?" Scully looked up from the blanket she had been studying. "He said it went perfectly. 'couldn't have gone better' were his exact words, I think." "Good, good." He turned his gaze back toward the window. It was awkward, this waiting for his agent to wake up. He didn't have any compelling reason to be there. He knew what he needed to know, that Agent Mulder was on the road to recovery. He decided to go. "Agent Scully, I'm going to head out. When he wakes up," he didn't finish his thought, because Mulder was waking up. Scully, who had turned away from Mulder to look at Skinner, followed the AD's gaze back to the man in the bed. She stood up. Mulder was moving. His feet stirred. Then his hands. He squeezed his eyes closed tightly, and then opened them. The first face he saw, as always, was Scully's. He said something, quietly, but the oxygen mask made it indecipherable. Scully leaned in and lifted the mask so she could hear him. "We have to stop meeting like this, Scully." She smiled and replaced the mask. "Well, then, stay healthy." Mulder's only reply was to roll his eyes. In doing so, he noticed the AD in the room. He settled his gaze on him. Skinner considered what to say. "I was just on my way out, Agent Mulder. Agent Scully says you are recovering nicely, which is just what I was hoping to hear." As he spoke he had moved toward the bed, and lightly rested his hand on Mulder's blanketed foot. He turned his attention to Scully. "I trust you'll keep me informed." "I will, sir." "Very good. Take care of yourself, agent." He vacated the room, perhaps a little too quickly. Scully watched Skinner leave, then looked at Mulder and shrugged. * * * * * "Ahhh, the next day. I love the next day. My patients are always human again on the next day. How goes it, Mulder?" Mulder was sitting up, picking at a breakfast of bland foods. He was back to receiving oxygen through the more-manageable nasal cannula. Scully was by his side. She had been trying to get him to eat. "I'm tired. I hurt. My throat is killing me. Breathing feels funny." Dr. Bellows' brow furrowed. "Funny how?" "I don't know. Just funny." Bellows sat Mulder up and put his stethoscope on Mulder's back, over his left lung. "Take a breath for me." Mulder did, and the doctor moved the instrument down. "Again." Mulder did. He repeated the process on Mulder's right side, and from the front. "Well, it sounds good to me. Try and describe it for me. Maybe it's normal." "I can't get a deep breath. It's like all I can do is take half a breath." Bellows smiled slightly. "That's about right for now. That's normal. It will improve. Your lungs are very elastic, but we traumatized that left one in a big way. It needs time. It has a lot of healing to do. We actually removed pieces of your lung, Mulder. We had to resect the blebs. We quite literally scooped them out and closed the lung over. You may not have a big scar to show for it, but this was major surgery. Don't pretend anything different. It takes time." As he spoke he was inspecting the small incision sites, and the chest tube that was still in Mulder's side. "And your throat is from the intubation. That will go away in a day or so. Cold things should help it. Ice chips. If it doesn't improve, we'll put you back on humidified oxygen for a while. That ought to relieve it somewhat." "How long do I have to stay hooked up to that?" Mulder motioned toward the Pleurivac. "Same routine as last time, really. We reexpanded your lung somewhat in the OR, but not all the way. It's best not to force these things, and let your body take care of it at its own pace." "Give me a ballpark, doc." "A week. At most. Has a respiratory therapist been in to see you yet?" "No." "Well, someone should be in soon. We want you to work those lungs this time, Mulder. Not only to get you healing, but also to get the anesthesia out. The last thing we want is for you to get pneumonia. So do what they tell you, okay?" "Yeah, sure." "Do you have any more questions?" He directed this to both Mulder _and_ Scully. The two agents looked at each other. Then Mulder asked. "So, when this is over, I'll be good as new? Able to go back to work?" "I can't see any reason why not. The surgery should prevent your lung from ever collapsing again, provided you give it adequate time to heal. And we'll make sure you do that this time." "Thanks." "I'll see you later." * * * * * Scully returned to Mulder's room after running down to the cafeteria for a quick lunch. She paused in the open doorway and looked inside. Mulder had the contraption the respiratory therapist had given him earlier that morning in his hand. He placed the hose in his mouth and sucked in air. There were three balls inside three tubes, and the first ball went to the top of its plastic tube. The second one went up 2/3 of the way. But the third one didn't move at all. He tried it again, with the same results, and it hurt. Frustrated, he dropped it onto his tray table, where it fell over. He didn't pick it up. "It's gonna take time, Mulder." Scully entered the room, and stood the device upright. "Scully, I've been given those things before. Like after my shoulder surgery. I always thought they were a joke. Sucked all three balls up with no problem. Now I can't even get two up." "But Mulder, you had surgery _on_ your lung this time. You shouldn't be able to get all three up yet. The therapist was impressed that you can get the second one up as much as you can. That's good. Just keep working on it. It'll get better every day, I bet." "Geezus, Scully, it's amazing how much you take breathing for granted, huh? In, out, in, out, all day, all night. It's kind of amazing, isn't it?" "Are you getting philosophical on me, Agent Mulder?" Mulder smiled. "No, not me! I guess this is just a case of 'you don't miss what you have till it's gone' on its most basic level." Scully smiled back. "You _are_ getting philosophical on me." * * * * * The plane started to move toward the runway for takeoff. Mulder gripped the armrests, and looked at Scully. "Well, here goes nothing." "You nervous?" "No. Not really. Yeah. Maybe a little." She grinned. "Me too. A little. But it's been four months, Mulder. You have to get back on that horse eventually." "I know. But this is one helluva reason to be afraid of flying. Bellows promised it would be fine. Right?" "Right." "You came prepared, though, right?" "I'll always be prepared, Mulder. I'll always carry a decompression kit with me, just in case. Don't worry about that. But we'll never need it again." She patted his hand on their shared armrest. "I know, Scully. I know." The plane built up speed. and took off. Scully never took her eyes off her partner. Mulder braced his head against the seat, clenched his jaw, and seemed to be waiting. The plane continued to climb, Mulder continued to wait, and Scully continued to watch. The pilot's voice came over the intercom: "Ladies and gentleman, we have reached our cruising altitude. . . ." Scully saw the tension leave her partner's body. He relaxed, grinned, and opened his eyes to look at her. "I'm fine." THE END