Page 58 of Run Wild Omega

“What’s happening?” My voice sounds foreign, rough. “Why is she in ICU? Why is she getting a transfusion?”

Dr. Evans sets the tablet down. “She developed a post-operative hemorrhage. Internal bleeding that wasn’t visible during the surgery. It’s not uncommon with this type of fracture—the trauma to the surrounding tissue can cause delayed bleeding from small vessels that constrict during the initial procedure.”

No. No. No.

“Is she—will she be okay?”

“The bleeding has slowed,” Dr. Evans says, holding up a hand. “We’ve given her two units of O-negative to replace what she lost. Her hemoglobin levels are stabilizing. But there’s another complication.”

I grip the side rail of the bed. “What kind of complication?”

He turns the tablet toward me. On the screen is an image of her leg, the skin swollen and taut around the incision sites. But it’s the measurement readings that make his expression so grim.

“Compartment syndrome,” he says. “The pressure inside the muscle compartments of her lower leg is climbing. The swelling from the surgery, combined with the trauma and now the fluid from the transfusion, is compressing the blood vessels and nerves inside the fascial sheath.”

I know what compartment syndrome means. I’ve seen it in the field—once, on a hiker who fell and got his leg pinned under a boulder. By the time we got him out, the muscle was already dying.

“If we don’t relieve the pressure,” Dr. Evans continues, “the tissue loses blood supply. The muscle dies. The nerve dies. Within six to eight hours, the damage becomes irreversible.”

Miles steps forward, his voice tight. “Irreversible as in…”

“As in amputation. If the necrosis spreads far enough, we lose the leg below the knee.”

The room goes very still.

I hear Dylan’s sharp inhale. I feel my own heartbeat hammering against my ribs so hard I’m sure the monitor will pick it up.

“There’s a procedure,” Dr. Evans says. “Fasciotomy. We make incisions along the affected compartments to release the pressure. It’s straightforward in concept, but⁠—”

“But she’s already lost blood,” Miles finishes. “Her hemoglobin is barely stable. You put her through another surgery right now, and she might not survive the anesthesia.”

Dr. Evans nods slowly. “That’s the risk. Her body is under enormous strain. Her blood pressure has been hovering in a range that makes any additional surgical intervention dangerous. If she crashes on the table…”

He doesn’t finish the sentence. He doesn’t have to.

“There has to be another option,” Dylan says. His voice is controlled, but I can hear the edge beneath it—the same edge he gets before he does something reckless.

“There is a conservative approach,” Dr. Evans says. “We can elevate the leg, apply cold therapy, and administer diuretics to reduce the swelling. We monitor the compartment pressures every thirty minutes. If they drop below the threshold, we avoid surgery. If they don’t…”

“Then we’re back to the fasciotomy,” I say.

“Exactly. But the window narrows. Every hour we wait, the tissue is dying. If we wait too long and then operate, we may be cutting into dead muscle anyway.”

“So what you’re saying,” I say slowly, “is that we can operate now and risk her dying on the table, or we can wait and risk her losing her leg.”

“Yes.”

The word hangs in the air between us, heavy and suffocating.

“Where are her parents?” I ask.

“Still en route. Daniel called ten minutes ago—they’re about twenty minutes out.”

“We can’t make this decision for her,” Miles says, and there’s a strain in his voice I’ve never heard before. “We’re not family. We’re not⁠—”

He stops. We all know what he was about to say. We all know what we lied about in the consult room downstairs.

Maggie, who has been standing silently by the door, speaks up. “Dr. Evans, what’s the current compartment pressure reading?”