Page 12 of Fallen Empire
Blood pressure slightly elevated, but not dangerously so.
Oxygen levels—strong.
Dr. Alvarez leaned in to examine Savannah, gently lifting her eyelids and shining a penlight across her pupils. He spoke to her in a low, calm voice as he checked for responsiveness, pressing gently against her nail bed, brushing his knuckles along her collarbone, watching for any twitch of recognition.
After a moment, he stepped back and faced us with a measured expression.
“I’d like to order a new CT scan right away,” he said. “We need to assess brain function, check for any lingering swelling, and rule out complications like bleeding or hydrocephalus. If the imaging looks clean and her breathing trial is stable, we’ll move toward removing the ventilator this afternoon.”
I felt my breath catch, hope blooming in my chest like something fragile and desperate.
“It’s a positive sign that she attempted to speak,” he continued. “That, combined with the finger movement and eye response, tells us she’s trying to come out of the coma. The swelling has likely reduced significantly, but we want to be absolutely sure before we take any next steps.”
Ben leaned forward slightly. “And the ventilator?”
Dr. Alvarez nodded. “That’s where we go next. The process of removing a patient from mechanical ventilation is called extubation. It’s not something we rush unless her body’s ready. We’ll start by decreasing the vent support, then gradually weaning her off over the next hour to see how her lungs perform on their own.”
I swallowed hard. “So what happens now?”
“Now, we monitor. If her oxygen saturation stays stable as we reduce support—and if her CT scan confirms the swelling’s resolved—we’ll proceed with extubation later today. If not, we wait and reassess in twenty-four hours.”
He looked between us. “This is all encouraging. We’re not out of the woods, but she’s showing us signs of fight.”
My fingers tightened around the edge of the blanket draped over Savannah’s legs. Signs of fight. That was exactly who she was.
She just needed the rest of us to keep fighting with her.
“What should we expect after?” Ben asked, arms crossed tight.
“She may be confused, disoriented,” he said gently. “Some patients wake up agitated. Others remember nothing at all. There’s also a possibility she won’t be able to speak immediately, especially if her throat is irritated from the tube. But if she’s truly waking up, she’ll start showing more consistent signs—eye tracking, responding to voices, purposeful movement.”
“And if she doesn’t?” I asked, needing to know every possibility.
Dr. Alvarez met my gaze squarely. “Then we keep waiting. But for now… this is huge progress.”
He paused, like he knew what I needed before I even asked it. Like he needed to say what came next—for both our sakes.
“But I want you to keep in mind,” he continued gently, “her body has been through significant trauma. She came in with an existing concussion. On top of that, she sustained additional head traumas. Blunt force injuries that have resulted in internal bleeding. She has a hairline fracture in the femoral shaft of her left leg, two broken ribs, and a gunshot wound that, while clean, still tore through tissue and muscle near her heart. All of that—plus the time she’s spent intubated and unconscious—means she won’t just wake up and be okay.”
I nodded, trying to swallow the lump rising in my throat.
“She has a long road ahead,” he said. “Rehab. Pain management. Physical therapy. Emotional recovery. This,” he motioned gently toward the bed, “is the beginning of that process, not the end of it.”
He let the words settle.
And I felt them. Heavy, weighted, like they weren’t just about what was happening in this room… but about what was happening outside of it too. Like some part of him knew this wasn’t just recovery—it was a reckoning. That the violence done to her body was only the start of something bigger. That healing, in every sense of the word, was going to take a war of its own.
We weren’t at the end of anything.
We were at the edge of something that hadn’t even started yet.
“We’ll monitor her closely. I’ll be back in an hour to reassess. In the meantime, just keep talking to her. Familiar voices can make a world of difference.”
He gave us a small, encouraging smile before turning to leave.
The door shut behind Dr. Alvarez with a quiet click, leaving only the nurse behind as she adjusted the IV line and checked a few final readings on the monitor.
I sat frozen, still trying to catch my breath from the storm of information we’d just been given. Hope and fear warring for space in my chest.
