Sunday, September 29, 2013

Shards To A Whole: Chapter 209

McGee-centric character study/romance. Want to start at the beginning? Click here.

Chapter 209: Ducky

At the age of eighteen, Don Mallard, not yet nicknamed Ducky, was a medic in Korea. (Coming into contact with large numbers of American soldiers, who universally called him Duck or Ducky, eventually caused the name to stick.)

As a medic, he became a talented medical jack of all trades. In a pinch he could, and did, take off limbs, tie off bleeders, fish shrapnel out of wounds, debride burns. In many cases he did those things under fire, or during the transport part of moving wounded soldiers from the front to the back.

He also, and this is something most people would assume to be true if they thought about it, but generally don't think about, dealt with delivering (or helping to deliver) a lot of babies.

A general rule of thumb is that if you are located in a place with a very large number of young men, IE an army, and if that very large group of men has limited access to birth control/is unwilling to use said birth control (condoms) you will, in nine months' time, end up with a large number of babies. The fighting part of the Korean War lasted three years, and there were numerous fairly long truces. This resulted in lots of babies, and while it's true that usually, in less medically advanced cultures, the local midwife is in charge of these things, Koreans are (or at least were) pretty well convinced they were the superior race on Earth, and half-Korean/half-Anglo babies and their mothers were scorned and treated horribly, so being a medic, and often the only guy many of the soldier knew with any medical training, he got called in to help with deliveries when the woman's family and village shunned her.

Dr. Mallard circa 1985
He returned to Scotland after the war. Studied medicine at Edinburgh. Joined the RAMC, and spent the next thirty years in every hot zone the Queen was involved in. Over the course of that time, he's delivered a whole lot of babies.

He's not an obstetrical expert, and he knows that. But he also knows that for many years and in many places he was the only one around who had any medical training beyond that of the local midwife, and when things got hairy, he'd get called in. At the very least he could perform a tidy c-section and make sure the woman didn't come down with childbed fever after.

So it is with this background that he's looking at Abby's scans, Penny standing next to him, forwarding the information to one of her friends, Dr. Gladys Monroe, the current head of Obstetrics at John's Hopkins, (add opinion five to the list) and thinking about how much he enjoys living in a world where you can find this out ahead of time.

The entirety of his baby-delivering career was spent in a world where, should the placenta be badly located the only way to find that out was for the woman to begin hemorrhaging, or depending on the level of badly located, come down with a nasty infection when all of it was not properly delivered.

So, it is true that he's thinking this is not happy or joyous news, he's also greatly relieved to know this ahead of time.

Granted, he's been out of the game long enough that he has no idea what current standards of treatment are. Back in his day the standard was c-section followed by hysterectomy, desperately trying to stop the bleeding in time, hoping and praying the whole way through that the mother came through alive with the (almost always premature) baby written off as tragic collateral damage.

That's why Penny's emailing her friend. If anyone does know what the cutting-edge standard of care is, she will.

So, in this, Ducky is expecting his value as comforter and cooler, wiser head will be what comes into play.

And as such he has two goals, first and foremost to manage Jethro, who will probably be just as scared as Tim, if not more so in that he's already lost his wife, daughter, lover, and pseudo-daughter in Kate, and will feel like he has fewer options in dealing with that fear, because he'll want to be a rock for Tim and Abby. Secondly, no matter what actual medical advice Jimmy comes up with, he'll back that. Jimmy's OB residency was after the invention of ultrasound as a obstetrical tool and Georgetown's Medical School is a more than adequate program. So he's going to agree or defer to anything Jimmy has to say about this.

They head to Gibbs' place before going to Tim and Abby's. Ducky wants to tell Jethro himself, and give him a little time to get himself under control.

Penny stays in the car. While she may think that Patriarchal emotional norms for males are silly, she's also fully aware that that's the operating manual Jethro functions under. He can't allow himself to express any emotions in front of her other than anger or happy. Fear and sorrow, the likely response to this news, is private for him and can only be expressed alone or with very, very dear friends, like Ducky, and certainly not in front of a woman he barely knows.

She also knows, because Ducky told her, that she's on Jethro's "shit list" right now. He has not yet called to yell at her about Tim, but that's probably still in the offing. So she does not want her presence to give him something other than Tim and Abby to focus on, not right now at least. Depending on how scared he gets, having something to get angry at may be useful. (After all, forty years as a Navy wife means she's got a few tricks up her sleeve when it comes to managing scared men who feel like they're not even allowed to feel fear, let alone know how to deal with it.)

They got you checking up...
So she texts with her friend, sees that Dr. Draz is on the ball and knows what she's talking about, and that right now, wait and see is the wisest course of action.


"They got you checking up on me now, too?" Gibbs asks, sanding the slats of the crib. This is the last, final sanding, then there'll be some buffing with a soft cloth, but by this weekend (barring a hot case) it'll be done.

Unfortunate news...
"If you mean, have I been recruited into Anthony and Timothy's conspiracy to keep you from spiraling into self-destructive behavior, no. They are 'looking out for you' on their own."

"So, what brings you down here at nine on a Monday?"

"Unfortunate news, I fear." And he explained, calmly and gently, what he'd seen in the scans, what Dr. Draz had put in her notes, and how all of that seemed reasonable to him.

He watches Jethro take it in, the slow realization that not only is this scary, but that there is nothing he can do about it, and unlike running into the radius of a bomb blast, there's no way he can go with her if this goes bad.

His darling girl.
It's Abby, his darling girl--because for as much as he loves Ziva, and he does truly love her, and for as rapidly as Breena is becoming his, as well, Abby's his little girl--in danger, and he can't protect her from it.

It is, literally, his worst nightmare.

Jethro's leaning against the crib, clutching the edge of it hard, not looking at Ducky, and Ducky can see he's immediately jumped to the worst case scenario. So he steps closer, puts his hand on Jethro's and says, "Jethro, they are going to be fine. The doctors know about it. They're keeping watch and giving Abigail and Timothy very good advice on how to proceed."

"If it's going to be fine, why are you down here?"

"Because they are scared, Jethro, and should be. Just because it will be fine in the end does not mean getting to the end will be easy or pleasant. And because you are scared and need a friend right now."

"I can't lose another one, Duck."

"I know, and you aren't, not like this."

"You ever deal with something like this?"

"No." A long and varied medical career taught Ducky that if the truth can do no good, if it can only bring pain and worry, then you lie and you lie convincingly and you feel no guilt about it. "First, do no harm," doesn't only mean avoid treatments that will make the case worse. It also means not scaring the patient or the patient's family with out of date information that has no bearing on the situation at hand.

"If they terminated, would she be okay?"

"Jethro! Stop it, right now. Abigail is going to be fine. She's never more than twenty minutes away from medical care. If something happens at work, Jimmy and I are less than two minutes away. At home, they are three miles from a hospital. And I have a feeling Timothy will be unwilling to let her get much further from a hospital than that. She will be fine. This is upsetting and scary, and may involve a rather unpleasant and bloody birth experience, but she will be fine. Kelly will be fine."

Gibbs is staring at the ceiling of the basement. Ducky isn't sure if he's bottling everything up or praying. Probably both.

"Doc says she'll be okay?"

"Her doctor's notes indicate that right now they're just waiting to see what happens next. She's not even on bed rest, Jethro. Jimmy sent me her notes and the scans, and her advice seems reasonable to me. I think he concurs. Penny has emailed everything to one of her friends, who is the head of Obstetrics at John's Hopkins, and should be hearing back soon."

He inhales deeply and says, "Okay," exhales slowly through gritted teeth. "And you're here because we're going over there, right?"


Ten minutes later, (Gibbs drove. Ducky and Penny both have mild whiplash from the speed he was going.) they walked into Tim and Abby's house and caught Jimmy explaining about possible worst case scenerios.

As Ducky said, "Dr. Palmer, I concur," Gibbs headed for Abby, kneeling on the floor next to her, glancing once at the sketch in front of them, and then wrapping around her, kissing her forehead.

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