Page 66 of Shadows of Recovery

Tristan offered a reassuring smile. “I know it feels that way, but we’re going to get you through this.” He turned to Matt. “Let’s get him started on our withdrawal management protocol. He needs more support than he’s been given.”

Matt nodded and began preparing the necessary medications. Tristan examined Jake, listening to his heart and lungs, gently pressing on his abdomen.

“Jake, your preadmission ECG was normal. Your bloodwork is showing some issues from your heavy drug use. Hopefully, once we get you detoxed, we will see an improvement.” Tristan sounded encouraging, but internally he was furious. Letting patients writhe in pain was not acceptable.

Jake's hands trembled as he clutched the sheets, his knuckles turning white with the effort of holding on. Beads of sweat dotted his forehead, evidence of the fierce battle raging within him as he fought to break free from the grip of addiction.

Tristan's heart ached for the police officer as he watched the struggle play out before him. He knew all too well the pain and desperation that came with medication withdrawal, the relentless cravings that ate at him. The pangs Kay got him through.

"Focus on your breathing, Jake," Tristan urged, his voice a steady anchor. "In... and out. You're stronger than you know.” He breathed with him.

Jake's breathing began to steady as he nodded.

"That's it.” A soft smile tugged at the corners of his lips. "You're doing amazing, Jake. One breath at a time."

Tristan handed him a fresh bucket. A second later, Jake doubled over, retching. Tristan had seen this too many times and knew it was coming.

Matt grumbled under his breath. He too was annoyed the man was suffering and handed him a bottle of water, his voice tinged with a western twang. "Rinse and spit," he instructed. “It’s gonna get better in a little bit.”

Jake followed his guidance, his movements sluggish yet determined as he rinsed his mouth and spit into the bucket.

Tristan and Matt assisted Jake in changing into the Institute's pajamas. Comfort for the patient at Blackwell Institute was the most important thing, especially during this initial challenging time, and the soft, practical garments would make Jake's stay more manageable. He’d be identifiable as a patient in the acute unit. Plus, they allowed for easy access if medical personnel needed to start IVs—a necessary precaution in cases like Jake's.

"Start an IV of ringers, 500 cc at 150 ccs per hour, then switch to saline,” Tristan instructed Matt, his tone firm. “Draw another full blood panel covering liver and kidneys, and, Jake, can you try to give us a urine?" Hydration was crucial, especially given the toll withdrawal could take on the body.

As Matt drew blood and started the IV, Tristan drew up ten milligrams of buprenorphine into a syringe. He injected the medication into the muscle of Jake's right arm. The buprenorphine would offer some relief from the relentless grip of withdrawal. “Let’s also give him eight milligrams of Zofran IV.”

Next, Tristan administered a dose of clonidine to help alleviate symptoms like the muscle aches, nausea, and insomnia that would be plaguing Jake. The small white pill seemed almost insignificant in the face of Jake's overwhelming discomfort, but Tristan knew its potential to provide some much-needed relief. He watched closely as Jake settled back into bed, his body still trembling slightly from the withdrawal.

The minutes ticked by slowly, each one a small victory in Jake's tough journey to recovery. "Thanks, Doc. It's starting to take the edge off," Jake murmured.

As Jake’s eyes began to flutter closed, Tristan's hand ran through his own thick light brown hair as he focused on his patient. "Alright, Jake, I'm going to write some more orders. I promise, in a few days, you'll feel less like your skin is crawling."

Jake's eyes flickered with a mixture of hope and desperation as he listened to Tristan's words.

“Matt will be with you overnight. Any questions, Matt can call me.”

After ensuring Jake was stable, they stepped out of the room. “Thank you for your help, Matt. I know this isn’t your shift. Keep a close eye on him,” Tristan said. “His electrolytes are skewed slightly, and his ECG is irregular now. Keep him on the monitor.”

“Of course,” Matt replied. “And about Kay…”

Tristan sighed. “I know. I’ll have to address it. But right now, I need her to share the patient load until Ellen Boyle is fully up to speed. I’ll keep her off acute admits, and please keep her away from Sophie. One more thing—call me if there’s a problem.”

As Tristan walked back to Sophie’s room, he couldn’t help but feel the day pressing down on him. But seeing Sophie’s peaceful face as she slept reminded him why he was doing this. He leaned down and kissed her forehead softly, whispering, “We’ll get through this, Sophie. Together.” With that, he stepped into the hall, closing the door so as not to disturb her.

* * *

Instead of going home,the home he shared with Sophie, Tristan walked back into the doctor’s lounge to write orders for Jake, his mind swirling. The day’s events had left him feeling drained and vulnerable. Sophie’s presence in his life had stirred memories he had buried deeply. Kay’s words kept echoing in his mind.

“You know she reminds you of Mimi,” Kay had said, her voice dripping with contempt. And she was right. Sophie did remind him of Mimi, his late wife. The resemblance wasn’t physical, but in the way Sophie’s strength and vulnerability intertwined, much like Mimi’s had. The memory of his failure to save Mimi ate at him, a relentless reminder of the past. He couldn’t fail Sophie. Not again.

He stared at the picture of Mimi he kept in his wallet, her smiling face a painful contrast to the grief that followed her death. Vicodin had been a refuge then, numbing the pain, until Kay found him at his lowest. She picked him up off the floor, helped him stop pill popping, detoxed him and gave him the strength to face each day. He owed her a debt he could never fully repay.

But now, Kay’s behavior was jeopardizing the very patients they had sworn to protect. Her negligence and jealousy were becoming increasingly dangerous. The incident with Jake Daniels was the final straw. He had to confront her, put an end to her irresponsible actions. But it was complicated. The lines between gratitude, guilt, and responsibility were blurred.

Taking a deep breath, he found Kay in her office, her face a mask of apathy as she scribbled notes. “Kay, we need to talk.”

She looked up, her eyes narrowing. “What now, Tristan? Another patient you think I mishandled?”

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