"So how's the wedding planning going?" Maggie asks a month later. She has just finished her sixth surgery for the day and is ready for a coffee fix.
She pulls out the green fizzer she bought from the vending machine and chews on it. She shrugs, "No, I'm really bad at planning, and the wedding planner Antonio's mom recommended costs like five paychecks"
"You know my cousin's cousin is a really good wedding planner. I can set it up for you? She owes me a favour"
"You can do that?"
"Yeah babe"
Sienna smiles brightly, "I owe you. Thanks"
"I'll hold you to it" She smirks having no intentions to cash out.
Sienna kisses Maggie on the cheek with a beaming smile, "You're the best"
Sienna's pager goes off in the middle of her conversation with Maggie.
"Incoming" She says and soon the nurse and the doctor are in action for the ambulance.
"What do we've got?" Sienna asks as soon as the ambulance halts.
"24 years old, we picked her up in the field. She has trouble breathing"
Sienna frowns as she sees the blood trickling out the girl's neck, "What happened here?"
Katrine looks like she wants to say something but Peter has a warning look on his face shutting Katrine up completely.
"Went through the wrong pipe, that's all"
Sienna sighs with a hesitant nod. She knows she can't do anything about this now plus the girl needs her help more.
"Let's get her to trauma 1. Page the burn unit and plastic surgery. Start an IV"
"Copy that doctor"
"I need you two to write up a report right now" Sienna tells the paramedics before running down the hall to her patient.
**
**
Sienna is on a warpath after the fourth patient was brought in by the same paramedics – all have clotted blood in their airways.
"Are you sure about this?" Maggie asks her.
"I don't know what to be sure of Maggie but I'm telling you, all my patients came in healthy, paramedics said they couldn't breathe. I checked their airways – it wasn't restricted. But they all had ruptured larynx and clotted blood in their airways. Now, all four are dead before I could even treat them"
"Then you will have to tell Chief Boden and Sharon. This could be negligent homicide"
Sienna scrunches up her face in frustration, "I hope to God this was just accidents and not paramedics trying to kill innocent people."
"Go tell Miss Goodwin, immediately."
After informing Sharon, the chief of services immediately told her to go update Chief Boden since it happened in one of his houses.
Sienna takes Maggie with her to Firehouse 51. When they get there they are welcomed by Kelly and the other guys from Squad 3.
"Hey!" Kelly grins as he stands up to hug them. "What brings you two to our house?"
Sienna gives him a small smile, "We need to discuss something with Boden, is he in?"
Kelly nods, "In his office."
She squeezes his shoulder and the two of them walk into Boden's office.
He looks surprised to see them but welcomes them with a warm smile. Maggie closes the office door.
"I hope I'm wrong about this chief and I brought Maggie here to back me up." Sienna stutters so Maggie cuts in; "This is about two of your paramedics, Katrine and Peter."
She shows him the four cases, and the reports Peter wrote up.
"I have reason to believe that these are not an accident. They all came to me with alleged airway restrictions which were false. They all got intubated by the EMS. Their airway pipes were damaged in the process causing them to bleed internally."
"Are you absolutely sure of these allegations Roberts?"
Sienna clenches her jaw, "I was taught that there's no such thing as a coincidence sir, four different cases with the same MO; all brought in by the same paramedics. I'm not 100% sure but I also know we can't look the other way."
"I'm going to handle this Sienna, I'll update you every second."
Sienna gives him a small sad smile, "I hope I'm wrong chief."
**
When the two get back to Med, Antonio and Kevin are there updating a patient about her family member. Maggie squeezes her shoulder, "You did good today Si, if it's not true then you brush this off and if it is true then you get negligent paramedics off the street."
"Thanks, babe" The nurse nods with a smile and walks away
Antonio smiles softly when he spots her at the nurses' station.
"Hey baby" Antonio walks up to her, his smile drops when he sees the look on her face, "You okay?"
She nods, "Just a bad day, are you done with shift?"
"Nah, not yet" He murmurs, "I'll see you tonight?"
"Love you" He murmurs smiling when she replies back. She greets Kevin and watches as both leaves.
Her pager goes off 911 so she gets suited up and then runs back to the pit,
"Talk to me" Sienna opens the ambo door to reveal Gabby dressed in plain clothes. On the gurney is Herrmann.
"Cruz's friend Freddy knifed him in the waist. His BP is down; losing a lot of blood."
"Get him to trauma four; page OR and get a portable X-Ray. I need O-NEG and a lot of it. Let's move it" Sienna instructs.
She looks over at the 51 family, "I'll take good care of him"
She runs into the trauma room.
"Herrmann, can you hear me?"
"His pupils are unresponsive; Herrmann, Herrmann, it's Sienna. You're going to be okay."
"Is my OR ready?" She asks the nurse.
"OR 2"
"Okay, hold me up. Let's get going. Torres, I need you to keep the elevator open. Go!"
She steps up the gurney and straddles Herrmann as she tries to keep the bleeding to stop while packing his wound with gauze.
They rush Herrmann off to the OR; while Maggie and her nurses are prepping Herrmann Sienna scrubs in.
**
The entire 51 are in the waiting area of Chicago Med waiting for news on Herrmann. Cindy sits in the front with Gabby and Boden.
"We know anything?" Kelly asks.
Mouch shakes his head as he rubs a hand over his face in worry, "Roberts is in there with him."
"He'll be fine" Casey murmurs, "It's Herrmann, he'll pull through."
Joe sits in the corner beating himself up. It is his fault that Herrmann is in that OR right now. He should have never brought in Freddy.
"Doc" Boden alerts them all of Sienna walking towards them.
"How is he?" Cindy stands up immediately, followed by the 51 family.
"We have given Herrmann several units of blood; he's stabilized. The knife went through his liver; diaphragm and lungs so we put a tube into his chest to re-inflate the lung and help him breathe. We're hopeful that the bleeding has stopped since we don't see anything on the CT."
"When will you know?" Cindy asks
Sienna takes a deep breath, "The next several hours are critical."
She stays quiet while they all try to grasp the news. "Cindy, you can come to see him."
**
"Sienna" Gabby runs up to her. "Is he going to be okay – medical expert to medical expert"
Sienna sighs, "He's not out of the woods and I have a resident sitting on him 24/7. He's strong as hell."
Gabby frowns, "thanks"
"I'll update you every change. I promise. Right now, Herrmann is my main priority."
She smiles softly, "Thank you Si"
**
"Richards" Sienna walks into Herrmann's room to find the resident on his case going over his file. "How's his breathing and vitals?"
"Still normal, he's losing blood"
"Speed up those transfusions. Let's get his white blood cell count up."
"On it"
**
"Sienna" Cruz runs up to her, he looks disheveled and worried.
"Hey Joe, you okay?"
"I brought in Freddy, you know, and I know everyone is blaming me for this. If Herrmann-" he trails off but Sienna knows he was about to say 'if Herrmann doesn't make it'
"Hey" She puts a hand on his arm, "This wasn't your fault. You tried to do a good thing by letting Freddy see a different life than the one he has now, you tried to help him. What he did to Herrmann – that's on him. You need to stop beating yourself up and be there for your brother."
Before he could say something, she gets paged 911 to Herrmann's room.
"Shit, I need to go"
"Wait, is that Herrmann, Sienna?!"
"Joe, stay put."
She runs into Herrmann's room.
"Stats are falling 80%."
Sienna takes off her stethoscope and listens to his heartbeat. "Hey Herrmann, I need you to take some nice easy breaths."
"He's crashing" The resident says.
"Nice and easy breaths Herrmann" She tells him again but he keeps on crashing.
"We need a BIPAP and an EPI in here now" Sienna yells.
The resident hands it to her
"We need that BIPAP on him now. Give him 125 milligrams of Methicillin"
"Right away doctor"
"I need a stat portable X-Ray" she continues giving orders to the residents, trying like hell to get his heart rate to slow down.
"Stats are back up, 94%. He's breathing better" She finally says after the drug is in his system. He's worse than she thought.
**
"What happened in there?" Cindy asks as tears stream down her face.
Sienna looks Gabby and Cindy both in the eyes, "Herrmann developed what we call TRALI. Transfusion-related acute lung injury. It's a reaction to the antibodies and blood products especially plasma. It sent him into respiratory distress. We can treat these symptoms with steroids and BIPAP but if it happens again we will need to intubate him and put him on a breathing machine."
Cindy looks at Gabby with worry clear in her eyes. The paramedic speaks up, "What about the liver bleed?"
"The liver bleed is under control. I'm more worried about his respiratory issues right now"
**
"I need to do more Connor. I need to fix him and steroids won't help."
The blonde trauma surgeon is busy wracking her brain for ways to fix Herrmann. The waiting game is making her anxious and frustrated. She's not used to waiting.
Connor looks at the file again, "It's his lung that is deflating right?"
"Right"
"What about a lung transplant?"
Sienna frowns, "His white blood cell count is too low"
Connor sighs, "if only there was a way to take his lung out and put it back in hey?"
Just then she gets an idea. It's a field procedure she did back in Afghanistan a few times, it's risky but way better than sitting on her ass doing nothing but wait.
Her face light up, "You're a genius"
"What did I do?" She hears him ask faintly in the background but she's already gone to ask permission to his family.
There was a lot of hesitation from Cindy but she agrees nonetheless for Sienna to do an internal lung transplant.
**
With a much lighter mood Sienna scrubs out of the OR. Herrmann is back to normal. He's fine. The surgery worked.
She walks to the 51 family – all of them pacing around in worry but stops to look at her when she gets closer to them.
"The surgery was a success" They all breathe out in relief. "It worked, he's going to be just fine."
Cindy cries out in relief as she hugs Sienna tightly. "Thank you, thank you so very much."
The blonde smiles, "I will keep him here for a few days to observe him. You guys can go see him in half an hour, just check with Maggie."
"Thank you Si" Gabby smiles brightly. "Thank you."