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His muscles tired and slightly aching, Aidan pushed himself away from Arcade's torso after he finished another round of compressions so he could squeeze the ventilation balloon twice and send some oxygen down the open throat holding plastic tubing. He was so concentrated on the fight for Arcade's last hope of survival that he started to sweat, his hands went cold but he was lucid, conscious and motivated to hold tightly on the small chance of his patient to recover from this horrific accident. As soon as he started the next set of chest compressions, he affixed his eyes on the monitors as it displayed and uttered Prepare defibrillation once again; it would be the fourth shock Arcade had to endure and the doctor wasn't sure if it was useful at all, starting to doubt the green, spiky line was a fibrillation and started to suspect it was a descent into an asystole. He injected one shot of adrenaline into the pilot's catheterized vein and he was ready prepare for another one, but he knew the unbelievably slim chances of an asystole recovery outside hospital conditions: <2%. But he was willing to struggle, sweat, bleed and cry for that minuscule chance, hoping that Arcade would be that one rare patient that will live to tell the story of his own resurrection. As soon he was done with the chest compression set, he punched the charge button with a snap of his arm in order to lose as little time as possible and then took the balloon again in his hand, squeezing it twice. The morbid alert turned up as soon as he got through the eleventh compression and immediately aborted the procedure so he could administer the shock, Arcade's nervous system reacting to the shock with a sudden contraction of the hands. Aidan anxiously awaited for the readings to come up, but to his dismay, there was still no stable pulse, confirming his greatest fear: Arcade's heart was shutting down and the doctor just realized why everything happened in this particular order.
The whole chain reaction started when he mobilized Arcade's body from his mangled GEAR, he knew the risks of putting in motion a patient with multiple injuries that affected the venous system of the patient. Arcade must have formed multiple blood clots that got sucked in by the venal flow, or maybe it was one huge chunk that got separated into smaller pieces: one surely got into the bronchial artery, causing pulmonary embolism, another must have reached the cervical region of the spinal cord, cutting off the phrenic nerve. Another one just blocked the coronary artery, resulting in a lethal thrombotic storm. Aidan first decided against anticoagulants, knowing that the patient would soon end up under the scalpel and most likely bleed from having the multiple shrapnel buried in his body surgically removed; there was that and the wound he clogged with gunshot wound microsponges. The fibrillation-like spikes gave Aidan hope that rescue was still possible, blaming it on hypovolemia and hypotension instead of a blood clot reaching the coronaries. The dog now faced a tough decision, one of the toughest in his medical life, in fact: he could inject anticoagulants using a very risky and kludge-y procedure, but the risk involved a massive hemorrhagia that would kill Arcade anyway, or just leave the poor sod go and get his eternal rest. With a patient that hadn't suffered any trauma like the dying pilot and treated with anticoagulants, one would still be on edge about the internal bleeding side-effect, but in Arcade's case, he'd become a fountain of blood after a strong enough injection to dissolve the clots; thing is, the poor guy was already hypovolemic from the sudden blood loss, his spleen couldn't possibly eject enough blood to compensate for the heavy loss and his bone marrow could not produce erythrocytes quickly enough to nullify another bleed-out. Honestly, Aidan preferred to just jump out of the chopper rather than to be the one responsible with the decision making, but this is what all those years of medical training boiled down to: deciding the next step in order to assure a patient's survival. Or in this case, untimely demise. Would he be the one to declare Arcade's death, or will he pass down the decision for the crash team waiting at the landcrawler, after they would struggle to keep him alive, only to come to the same conclusion too?
It took a half of a second for the whole train of thoughts to rush through the doctor's brain and end up with the decision, sending powerful chills down his furred back. Aidan closed his eyes and sighed in exhaustion- no, frustration; he halted the motion of his body, though his muscle memory urged him to keep pressing down. He took the electrodes and the defibrillation pads off Arcade and set them aside, so he could completely cover his destroyed, defeated body. He stored the dirty electrodes and pads in a special compartment of his kit and took off his gloves. He brought up his left arm, where he found his wristwatch, telling him the precise time of that day, but the heavy knot in his neck prevented him from speaking into the comms; like every other doctor, he hated to give the bad news, not because he was afraid of people's reaction, but he could not stand the cold tone he had to adopt while delivering the morbid, ritualistic speech. Aidan got a grip of himself, counted to three and opened his mouth.
"Sir. Dr. Aidan Sykes, I am to declare GEAR pilot Arcade as: deceased. Time of death: 17:56:07. Cause of death: thrombotic storm. Cause of death detail: the thrombotic storm was most likely caused by multiple open injuries caused by shrapnel, thus facilitating the formation of blood clots. Mobilization of the patient caused them to be carried by the venous flux, anticoagulants were no go as he would have risked a massive bleed-out during the surgical procedure. My suspicion: three clots have formed, one caused pulmonary embolism, another shut down a part of the spinal cord controlling diaphragm contraction and the last one clogged the coronaries. A fibrillation-like pulse indicated immediate CPR treatment. Fibrillation was an artifact caused by bradicardia associated with asystoloe. Patient was hypovolemic and hypotensive. The presence of the clot in the coronary artery rendered the resurrection procedure useless. Procedures: IV catheter with isotonic solution, foil cover to prevent hypothermia, emergency cricothyrotomy with very good results, emergency CPR with four defibrillations and one epinephrine injection."
"Less-bullshit translation: Arcade got hit hard, I tried everything I could do with the little I had. If I were to inject him with blood thinners, he'd bleed out during the operation, no guarantee he'd make it. I preferred to take his death on my behalf instead of throwing my responsibility over to someone else. I tried everything to keep the poor sod alive, but from this point on, we'd waste resources on a corpse. I am very sorry, sir. I'll give him the final honorary."
Like that, Aidan spilled out his frustration and blunt honesty. He didn't expect to be praised or rebuked, he did his job the best he could and fought fiercely for Arcade's life, yet, he was trying to stop a derailing train. The dog then laid his uncovered hand over Arcade's, starting to mutter a low chant mostly to himself.
I, son of Arvara, have fulfilled my duty, yet, my blood has been taken away. While your warrior was with us, he watched over my brothers and in the time of need, I've watched over him. You, oh dear brother, lay down to sleep, for it is my turn to stand vigil; for my voice will guide you through dark. And hope that one day, we will be again, brothers.
Aidan handled the body over to the crash team, his face was a mixture between resignation and calmness and once the transfer was done, him and Ken were off and away, returning to the field. With the news of another accident, Aidan felt something like a burning knife twisting his core and immediately knelt over to prepare the kit for another emergency. He then half-entered the cockpit of the Sky Hawk and placed a limp hand on Ken's shoulder.
"Kuraiko's down too. Him, I promise, will make it. Drop me off to the mines, screw the GEAR."
"Ken. I hope this wasn't the first man to die in your helo. If he is, I'll buy you a six pack."